National efforts to improve door-to-balloon time results from the Door-to-Balloon Alliance.
OBJECTIVE
The purpose of this study was to determine if enrollment in the Door-to-Balloon (D2B) Alliance, a national quality campaign sponsored by the American College of Cardiology and 38 partner organizations, was associated with increased likelihood of patients who received primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) being treated within 90 min of hospital presentation.


BACKGROUND
The D2B Alliance, launched in November 2006, sought to achieve the goal of having 75% of patients with STEMI treated within 90 min of hospital presentation.


METHODS
We conducted a longitudinal study of D2B times in 831 hospitals participating in the National Cardiovascular Data Registry (NCDR) CathPCI Registry, April 1, 2005, to March 31, 2008.


RESULTS
By March 2008, >75% of patients had D2B times of < or = 90 min, compared with only about one-half of patients with D2B times within 90 min in April 2005. Trends since the launch of the D2B Alliance showed that patients treated in hospitals enrolled in the D2B Alliance for at least 3 months were significantly more likely than patients treated in nonenrolled hospitals to have D2B times within 90 min, although the magnitude of the difference was modest (odds ratio: 1.16; 95% confidence interval: 1.07 to 1.27).


CONCLUSIONS
The D2B Alliance reached its goal of 75% of patients with STEMI having D2B times within 90 min by 2008.
Bradley
Elizabeth H
EH
Section of Health Policy and Administration, Yale School of Public Health, New Haven, CT, USA. elizabeth.bradley@yale.edu
Nallamothu
Brahmajee K
BK
Herrin
Jeph
J
Ting
Henry H
HH
Stern
Amy F
AF
Nembhard
Ingrid M
IM
Yuan
Christina T
CT
Green
Jeremy C
JC
Kline-Rogers
Eva
E
Wang
Yongfei
Y
Curtis
Jeptha P
JP
Webster
Tashonna R
TR
Masoudi
Frederick A
FA
Fonarow
Gregg C
GC
Brush
John E
JE
Krumholz
Harlan M
HM
D015906:Angioplasty, Balloon, Coronary / Q000592:standards*; D017598:Efficiency, Organizational; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D011785:Quality Assurance, Health Care; D012042:Registries; D013997:Time Factors; D014481:United States