Barriers Associated With Door-to-Balloon Delay in Contemporary Japanese Practice

Access this Article

Author(s)

Abstract

<p><b><i>Background:</i></b>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.</p><p><b><i>Methods and Results:</i></b>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, 68–115 min) 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 VA-ECMO. 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).</p><p><b><i>Conclusions:</i></b>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.</p>

Journal

  • Circulation Journal

    Circulation Journal 81(6), 815-822, 2017

    The Japanese Circulation Society

Codes

  • NII Article ID (NAID)
    130005679702
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • ISSN
    1346-9843
  • NDL Article ID
    028184229
  • NDL Call No.
    Z54-B860
  • Data Source
    NDL  J-STAGE 
Page Top