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 language | English |
|---|---|
| Pages (from-to) | 815-822 |
| Number of pages | 8 |
| Journal | Circulation Journal |
| Volume | 81 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2017 |
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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; Kohsaka, Shun.
In: Circulation Journal, Vol. 81, No. 6, 2017, p. 815-822.Research output: Contribution to journal › Article
}
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 - Kohsaka, 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
C2 - 28228609
AN - SCOPUS:85019755664
VL - 81
SP - 815
EP - 822
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 6
ER -