Door-to-Balloon Time Crucial in Coronary Intervention

Yet only one-third of patients are treated within performance target of 90 minutes

THURSDAY, Oct. 18 (HealthDay News) -- Patients undergoing percutaneous coronary intervention (PCI) have a better chance of successful treatment and survival if they are treated within 90 minutes of experiencing ST-elevation myocardial infarction, but little progress has been made on achieving this target time, according to a review published in the Oct. 18 issue of the New England Journal of Medicine.

Brahmajee K. Nallamothu, M.D., of the University of Michigan Medical School in Ann Arbor, and colleagues reviewed current knowledge on time to treatment in primary PCI and found that while some studies did not find an association between door-to-balloon time and outcomes, most studies did conclude that faster time to treatment led to fewer adverse cardiovascular events and better long-term survival.

However, according to available data, performance targets for reducing time to treatment for PCI have not been met, and there are less improvements in this area than other aspects of treatment for myocardial infarction.

"Targeting improvement of door-to-balloon time at hospitals that already provide primary PCI is the aim of current efforts," the authors write. "Any improvements in access to primary PCI…must be balanced against the use of immediate fibrinolytic therapy, which remains a reasonable alternative for reperfusion therapy in selected instances."

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