title: The development of door-to-angiography time in the last 14 years for patients with acute ST-elevation myocardial infarction treated with primary coronary intervention: Determinants and outcome. Results from the MITRAplus and OPTAMI registry.
abstract: OBJECTIVE
  To examine the development of door-to-angiography time (DTA) and to evaluate the impact of door-to-angiography time in patients with ST-elevation myocardial infarction (STEMI) on hospital and one-year mortality.
  
  
  RESULTS
  From 1994 to 2008, 5078 patients (pts) and known DTA with acute ST-elevation myocardial infarction were enrolled into the MITRAplus and OPTAMI registry in Germany. Our data showed a reduction of the door-to- angiography time from 80 min to 64 min in the last 14 years (P < 0.001). Over 80% of patients received an angiography less than two hours after admission. The main predictor of a shorter door-to-balloon time was a hypotension with a blood pressure lower than 100 mmHg (OR 1.46, 95%CI: 1.08-1.91). Whereas a history of prior myocardial infarction (OR 0.61, 95%CI: 0.45-0.84), a previous coronary bypass grafting (OR 0.55, 95%CI: 0.33-0.91), age older than 75 years (OR 0.78, 95%CI: 0.62-0.99) and a pre-hospital delay more than three hours (OR 0.78, 95%CI: 0.66-0.93) were independent predictors for a longer of the door-to-balloon time. In the multivariate regression analysis no influence was detected of door-to-angiography time on hospital or one-year mortality.
  
  
  CONCLUSIONS
  The DTA decreased in the last 14 years and is actually very short in Germany. We indentified predictors of a longer door-to-angiography time in clinical practice. Given the overall short in-hospital delay, the observed door-to-angiography time did not have influence on hospital and mid term mortality.
authors.affiliation: Klinikum Ludwigshafen, Herzzentrum Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany. frank@towae.com
authors.forename: Frank
authors.initials: F
authors.lastname: Towae
authors.forename: Claus
authors.initials: C
authors.lastname: Juenger
authors.forename: Harald
authors.initials: H
authors.lastname: Mudra
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Glunz
authors.forename: Eugen
authors.initials: E
authors.lastname: Hauptmann
authors.forename: Eberhard
authors.initials: E
authors.lastname: Grube
authors.forename: Thomas
authors.initials: T
authors.lastname: Voigtländer
authors.forename: Timm
authors.initials: T
authors.lastname: Bauer
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Anselm Kai
authors.initials: AK
authors.lastname: Gitt
authors.forename: Ralf
authors.initials: R
authors.lastname: Zahn
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome