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dc.contributor.authorBrennan, A.
dc.contributor.authorAndrianopoulos, N.
dc.contributor.authorDuffy, S.
dc.contributor.authorReid, Christopher
dc.contributor.authorClark, D.
dc.contributor.authorLoane, P.
dc.contributor.authorNew, G.
dc.contributor.authorBlack, A.
dc.contributor.authorYan, B.
dc.contributor.authorBrooks, M.
dc.contributor.authorRoberts, L.
dc.contributor.authorCarroll, E.
dc.contributor.authorLefkovits, J.
dc.contributor.authorAjani, A.
dc.date.accessioned2017-01-30T14:29:48Z
dc.date.available2017-01-30T14:29:48Z
dc.date.created2015-10-29T04:09:47Z
dc.date.issued2014
dc.identifier.citationBrennan, A. and Andrianopoulos, N. and Duffy, S. and Reid, C. and Clark, D. and Loane, P. and New, G. et al. 2014. Trends in door-to-balloon time and outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction: An Australian perspective. Internal Medicine Journal. 44 (5): pp. 471-477.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/39048
dc.identifier.doi10.1111/imj.12405
dc.description.abstract

Background: Guidelines for patients with ST-elevation myocardial infarction include a door-to-balloon time (DTBT) of =90min for primary percutaneous coronary intervention. Aim: The aim of this study was to assess temporal trends (2006-2010) in DTBT and determine if a reduction in DTBT was associated with improved clinical outcomes. Methods: We compared annual median DTBT in 1926 STEMI patients undergoing primary percutaneous coronary intervention from the Melbourne Interventional Group registry. ST-elevation myocardial infarction presenting >12h and rescue percutaneous coronary intervention was excluded. Major adverse cardiac events were analysed according to DTBT (dichotomised as =90min vs >90min). A multivariable analysis for predictors of mortality (including DTBT) was performed. Results: Baseline demographics, clinical and procedural characteristics were similar in the STEMI cohort across the 5 years, apart from an increase in out-of-hospital cardiac arrest (3.6% in 2006 vs 9.4% in 2010, P < 0.0001) and cardiogenic shock (7.7-9.6%, P = 0.07). The median DTBT (interquartile range) was reduced from 95 (74-130) min in 2006 to 75 (51-100) min in 2010 (P < 0.01). In this period, the proportion of patients achieving a DTBT of =90min increased from 45% to 67% (P < 0.01). Lower mortality and major adverse cardiac event rates were observed with DTBT =90min (all P < 0.01). Multivariable analysis showed that a DTBT of =90min was associated with improved clinical outcomes at 12 months (odds ratio 0.48; 95% confidence interval 0.33-0.73, P < 0.01). Conclusion: There has been a decline in median DTBT in the Melbourne Interventional Group registry over 5 years. DTBT of =90min is associated with improved clinical outcomes at 12 months. © 2014 Royal Australasian College of Physicians.

dc.publisherBlackwell Publishing
dc.titleTrends in door-to-balloon time and outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction: An Australian perspective
dc.typeJournal Article
dcterms.source.volume44
dcterms.source.number5
dcterms.source.startPage471
dcterms.source.endPage477
dcterms.source.issn1444-0903
dcterms.source.titleInternal Medicine Journal
curtin.departmentDepartment of Health Policy and Management
curtin.accessStatusFulltext not available


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