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Acute Coronary Syndrom

Abstract

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A systematic review of factors predicting door to balloon time in ST-segment elevation myocardial infarction treated with percutaneous intervention Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery Ticagrelor versus Clopidogrel in Patients with STEMI Treated with Fibrinolytic Therapy: TREAT Trial Oxygen Therapy in Suspected Acute Myocardial Infarction Early Natural History of Spontaneous Coronary Artery Dissection Colchicine Inhibits Neutrophil Extracellular Trap Formation in Patients With Acute Coronary Syndrome After Percutaneous Coronary Intervention Nonculprit Stenosis Evaluation Using Instantaneous Wave-Free Ratio in Patients With ST-Segment Elevation Myocardial Infarction Efficacy of High-Sensitivity Troponin T in Identifying Very-Low-Risk Patients With Possible Acute Coronary Syndrome

Review Article2012 May 17;157(1):8-23

JOURNAL:Int J Cardiol. Article Link

A systematic review of factors predicting door to balloon time in ST-segment elevation myocardial infarction treated with percutaneous intervention

Peterson MC, Syndergaard T, Bowler J et al. Keywords: ST elevation myocardial infarction, Door to balloon time, Percutaneous intervention, Prognostic factors, Systematic review

ABSTRACT


BACKGROUND - Door to balloon time is important in the outcome of ST-elevation myocardial infarction treated with primary percutaneous intervention. This review summarizes prognostic factors for door to balloon time in STEMI patients presenting to a PCI capable hospital.


METHOD - NLM Gateway and Cochrane CENTRAL are the primary data sources. Searched reports were screened by title and abstract and full texts were located for potentially relevant articles. References from the selected articles and relevant background papers were hand searched for additional reports. Articles were reviewed and assessed for risk of bias. The results are summarized without meta-analysis.


RESULTS - 90 papers are included in the review. Individual study quality was variable but was generally low. A number of patient characteristics, hospital characteristics, physician characteristics, care processes and "other" factors were associated with door to balloon time. Prognostic factors for longer times include: pre-hospital delay in presentation, cerebrovascular disease, absence of chest pain, lower PCI volume and specialization hospital, lower sum ST elevation, absence of Q waves and left bundle branch block. Shorter times were associated with: presentation during regular hours, PCI in a more recent year, 24 hour on site cardiology, pre-hospital ECG, single call to central page to activate the catheterization lab, ER physician activating the cath lab, lab staff arriving within 20 min of paging and culprit vessel PCI before full diagnostic angiography.


CONCLUSION - Understanding prognostic factors for door to balloon time can likely lead to improved quality of care for STEMI.