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Hospital Delay Reduces Survival in Primary Angioplasty

Researchers find that speed of angioplasty determines survival versus clot-busting drugs

MONDAY, Oct. 30 (HealthDay News) -- The survival benefit of angioplasty over clot-busting drugs for ST-elevation myocardial infarction declines with increasing door-to-balloon times and also varies with patient characteristics, according to a study published online Oct. 30 in Circulation: Journal of the American Heart Association.

C. Michael Gibson, M.S., M.D., of Harvard Medical School in Boston, and colleagues subtracted median door-to-needle (DN) time from median door-to-balloon (DB) time at a hospital, using data from 192,509 patients at 645 hospitals. In the study, 126,909 patients were treated with clot-busting drugs and 65,600 had angioplasty.

The researchers found that the longer the DB-DN time, the greater the likelihood of mortality. The DB-DN time at which survival with angioplasty was no better than that of clot-busting drugs also depended on the patient's age, duration of symptoms, and location of the infarct.

"As indicated in the American College of Cardiology/American Heart Association guidelines, both the hospital-based primary percutaneous coronary intervention-related delay (DB-DN time) and patient characteristics should be considered when a reperfusion strategy is selected," the authors conclude.

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