Barriers associated with door-to-balloon delay in contemporary Japanese practice

Nobuhiro Ikemura, Mitsuaki Sawano, Yasuyuki Shiraishi, Ikuko Ueda, Hiroaki Miyata, Yohei Numasawa, Shigetaka Noma, Masahiro Suzuki, Yukihiko Momiyama, Taku Inohara, Kentaro Hayashida, Shinsuke Yuasa, Yuichiro Maekawa, Keiichi Fukuda, Shun Kosaka

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe. Methods and Results: We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min. Median DTB time was 90 min (IQR, 68–115min) during the study period and there were no significant changes with year. Predictors for delay in DTB time included peripheral artery disease, prior revascularization, off-hour arrival, age >75 years, heart failure at arrival, and use of IABP or VAECMO. Notably, high-volume PCI-capable institutions (PCI ≥200/year) were more adept at achieving shorter DTB time compared with low-volume institutions (PCI <200/year). Conclusions: Half of the present STEMI patients did not achieve DTB time ≤90 min. Targeting the elderly and patients with multiple comorbidities, and PCI performed in off-hours may aid in its improvement.

Original languageEnglish
Pages (from-to)815-822
Number of pages8
JournalCirculation Journal
Volume81
Issue number6
DOIs
Publication statusPublished - 2017

Fingerprint

Registries
Peripheral Arterial Disease
Comorbidity
Heart Failure
Databases
ST Elevation Myocardial Infarction
icodextrin

Keywords

  • Acute coronary syndrome
  • Door-to-balloon time
  • Reperfusion
  • ST-segment elevation myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Barriers associated with door-to-balloon delay in contemporary Japanese practice. / Ikemura, Nobuhiro; Sawano, Mitsuaki; Shiraishi, Yasuyuki; Ueda, Ikuko; Miyata, Hiroaki; Numasawa, Yohei; Noma, Shigetaka; Suzuki, Masahiro; Momiyama, Yukihiko; Inohara, Taku; Hayashida, Kentaro; Yuasa, Shinsuke; Maekawa, Yuichiro; Fukuda, Keiichi; Kosaka, Shun.

In: Circulation Journal, Vol. 81, No. 6, 2017, p. 815-822.

Research output: Contribution to journalArticle

Ikemura, N, Sawano, M, Shiraishi, Y, Ueda, I, Miyata, H, Numasawa, Y, Noma, S, Suzuki, M, Momiyama, Y, Inohara, T, Hayashida, K, Yuasa, S, Maekawa, Y, Fukuda, K & Kosaka, S 2017, 'Barriers associated with door-to-balloon delay in contemporary Japanese practice', Circulation Journal, vol. 81, no. 6, pp. 815-822. https://doi.org/10.1253/circj.CJ-16-0905
Ikemura, Nobuhiro ; Sawano, Mitsuaki ; Shiraishi, Yasuyuki ; Ueda, Ikuko ; Miyata, Hiroaki ; Numasawa, Yohei ; Noma, Shigetaka ; Suzuki, Masahiro ; Momiyama, Yukihiko ; Inohara, Taku ; Hayashida, Kentaro ; Yuasa, Shinsuke ; Maekawa, Yuichiro ; Fukuda, Keiichi ; Kosaka, Shun. / Barriers associated with door-to-balloon delay in contemporary Japanese practice. In: Circulation Journal. 2017 ; Vol. 81, No. 6. pp. 815-822.
@article{2e714b376f994f7fa8c959d1be6e0fe2,
title = "Barriers associated with door-to-balloon delay in contemporary Japanese practice",
abstract = "Background: Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe. Methods and Results: We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min. Median DTB time was 90 min (IQR, 68–115min) during the study period and there were no significant changes with year. Predictors for delay in DTB time included peripheral artery disease, prior revascularization, off-hour arrival, age >75 years, heart failure at arrival, and use of IABP or VAECMO. Notably, high-volume PCI-capable institutions (PCI ≥200/year) were more adept at achieving shorter DTB time compared with low-volume institutions (PCI <200/year). Conclusions: Half of the present STEMI patients did not achieve DTB time ≤90 min. Targeting the elderly and patients with multiple comorbidities, and PCI performed in off-hours may aid in its improvement.",
keywords = "Acute coronary syndrome, Door-to-balloon time, Reperfusion, ST-segment elevation myocardial infarction",
author = "Nobuhiro Ikemura and Mitsuaki Sawano and Yasuyuki Shiraishi and Ikuko Ueda and Hiroaki Miyata and Yohei Numasawa and Shigetaka Noma and Masahiro Suzuki and Yukihiko Momiyama and Taku Inohara and Kentaro Hayashida and Shinsuke Yuasa and Yuichiro Maekawa and Keiichi Fukuda and Shun Kosaka",
year = "2017",
doi = "10.1253/circj.CJ-16-0905",
language = "English",
volume = "81",
pages = "815--822",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "6",

}

TY - JOUR

T1 - Barriers associated with door-to-balloon delay in contemporary Japanese practice

AU - Ikemura, Nobuhiro

AU - Sawano, Mitsuaki

AU - Shiraishi, Yasuyuki

AU - Ueda, Ikuko

AU - Miyata, Hiroaki

AU - Numasawa, Yohei

AU - Noma, Shigetaka

AU - Suzuki, Masahiro

AU - Momiyama, Yukihiko

AU - Inohara, Taku

AU - Hayashida, Kentaro

AU - Yuasa, Shinsuke

AU - Maekawa, Yuichiro

AU - Fukuda, Keiichi

AU - Kosaka, Shun

PY - 2017

Y1 - 2017

N2 - Background: Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe. Methods and Results: We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min. Median DTB time was 90 min (IQR, 68–115min) during the study period and there were no significant changes with year. Predictors for delay in DTB time included peripheral artery disease, prior revascularization, off-hour arrival, age >75 years, heart failure at arrival, and use of IABP or VAECMO. Notably, high-volume PCI-capable institutions (PCI ≥200/year) were more adept at achieving shorter DTB time compared with low-volume institutions (PCI <200/year). Conclusions: Half of the present STEMI patients did not achieve DTB time ≤90 min. Targeting the elderly and patients with multiple comorbidities, and PCI performed in off-hours may aid in its improvement.

AB - Background: Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe. Methods and Results: We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min. Median DTB time was 90 min (IQR, 68–115min) during the study period and there were no significant changes with year. Predictors for delay in DTB time included peripheral artery disease, prior revascularization, off-hour arrival, age >75 years, heart failure at arrival, and use of IABP or VAECMO. Notably, high-volume PCI-capable institutions (PCI ≥200/year) were more adept at achieving shorter DTB time compared with low-volume institutions (PCI <200/year). Conclusions: Half of the present STEMI patients did not achieve DTB time ≤90 min. Targeting the elderly and patients with multiple comorbidities, and PCI performed in off-hours may aid in its improvement.

KW - Acute coronary syndrome

KW - Door-to-balloon time

KW - Reperfusion

KW - ST-segment elevation myocardial infarction

UR - http://www.scopus.com/inward/record.url?scp=85019755664&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019755664&partnerID=8YFLogxK

U2 - 10.1253/circj.CJ-16-0905

DO - 10.1253/circj.CJ-16-0905

M3 - Article

VL - 81

SP - 815

EP - 822

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 6

ER -