Associated factors with delayed door to balloon time in STEMI patients

Introduction: Door to balloon time is a marker of primary Percutaneous Coronary Intervention (PCI) timeliness. Door to balloon time duration, associated factors and it's relation to outcomes are not similar in various centers. Herein we aimed to define these issues in our region.

Methods: In this study, 188 patients with ST-Elevation Myocardial infarction (STEMI) diagnosis eligible for primary PCI were included. Demographic, clinical, and time intervals from arrival in the hospital to patients' catheterization data were recorded. Patients were followed for six-month in terms of mortality and admission.

Results: After excluding patients with missed data, 174 patients were entered into the study. The mean age of patients was 60.8 ± 11.81 years, and 78% of patients were male. Median DBT was 70 minutes (IQR 25-75: 55-97 minute). One hundred and twentythree patients (71%) had a timely door to balloon time. Patients with delayed door to balloon time had lower age, lower prevalence of typical chest pain, and higher prevalence of PCI on Left Circumflex Artery (LCX) than the timely group, but these differences were not significant. (P-values were 0.068, 0.074 and 0.070 respectively). Delayed DBT was evident in three segments of the door to ECG, ECG to code, and code to cath times (P-values were < 0.0001, 0.009, and < 0.0001, respectively), but the cath to balloon time was not significantly different between the two groups (P-value: 0.159). Although in-hospital mortality was higher in the delayed group than the timely group, the difference was not meaningful. (11.7% vs 4.9%, P-value: 0.103). Six-month mortality and admission rate were not different between the two groups.

Conclusions: Door to balloon time was acceptable in this study and was comparable to developed countries. Albeit there is room for improvement due to modifiable delayed parts.