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    Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis

    Access Status
    Fulltext not available
    Authors
    Foo, C.
    Bonsu, K.
    Nallamothu, B.
    Reid, Christopher
    Dhippayom, T.
    Reidpath, D.
    Chaiyakunapruk, N.
    Date
    2018
    Type
    Journal Article
    
    Metadata
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    Citation
    Foo, C. and Bonsu, K. and Nallamothu, B. and Reid, C. and Dhippayom, T. and Reidpath, D. and Chaiyakunapruk, N. 2018. Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis. Heart. 104 (16): pp. 1362-1369.
    Source Title
    Heart
    DOI
    10.1136/heartjnl-2017-312517
    ISSN
    1355-6037
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/74628
    Collection
    • Curtin Research Publications
    Abstract

    Objective: This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers. Methods: We conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure. Results: 32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time-risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran's Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays. Conclusion: Longer door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time-risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA. Clinical trial registration PROSPERO (CRD42015026069).

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    • Re-examining the effect of door-to-balloon delay on STEMI outcomes in the context of unmeasured confounders: a retrospective cohort study
      Foo, C.Y.; Andrianopoulos, N.; Brennan, Angela; Ajani, A.; Reid, Christopher ; Duffy, S.J.; Clark, D.J.; Reidpath, Daniel; Chaiyakunapruk, N. (2019)
      Literature studying the door-to-balloon time-outcome relation in coronary intervention is limited by the potential of residual biases from unobserved confounders. This study re-examines the time-outcome relation with ...
    • Impact of door-to-balloon time on long-term mortality in high- and low-risk patients with ST-elevation myocardial infarction
      Yudi, M.; Ramchand, J.; Farouque, O.; Andrianopoulos, N.; Chan, W.; Duffy, S.; Lefkovits, J.; Brennan, A.; Spencer, R.; Fernando, D.; Hiew, C.; Freeman, M.; Reid, Christopher; Ajani, A.; Clark, D. (2016)
      © 2016Background Door-to-balloon time (DTBT) less than 90 min remains the benchmark of timely reperfusion in ST-elevation myocardial infarction (STEMI). The relative long-term benefit of timely reperfusion in STEMI patients ...
    • Inter-hospital transfers and door-to-balloon times for STEMI: a single centre cohort study
      Forsyth, René; Sun, Zhonghua ; Reid, C.; Moorin, R. (2020)
      Background Key performance indices such as door-to-balloon times have long been recognized as quality metrics in reducing time to care for patients with acute coronary syndromes (ACS). In the situation where patients do ...
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