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血流储备分数

Abstract

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Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW Fractional Flow Reserve-Guided Complete Revascularization Improves the Prognosis in Patients With ST-Segment-Elevation Myocardial Infarction and Severe Nonculprit Disease: A DANAMI 3-PRIMULTI Substudy (Primary PCI in Patients With ST-Elevation Myocardial Infarction and Multivessel Disease: Treatment Physiologic Characteristics and Clinical Outcomes of Patients With Discordance Between FFR and iFR Prognostic Implication of Thermodilution Coronary Flow Reserve in Patients Undergoing Fractional Flow Reserve Measurement Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve Relationship between fractional flow reserve value and the amount of subtended myocardium Fractional Flow Reserve-Guided Multivessel Angioplasty in Myocardial Infarction High-Resolution Cardiac Magnetic Resonance Imaging Techniques for the Identification of Coronary Microvascular Dysfunction
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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.

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