title: Improvements in door-to-balloon time in the United States, 2005 to 2010.
abstract: BACKGROUND
  Registry studies have suggested improvements in door-to-balloon times, but a national assessment of the trends in door-to-balloon times is lacking. Moreover, we do not know whether improvements in door-to-balloon times were shared equally among patient and hospital groups.
  
  
  RESULTS
  This analysis includes all patients reported by hospitals to the Centers for Medicare & Medicaid Services for inclusion in the time to percutaneous coronary intervention (acute myocardial infarction-8) inpatient measure from January 1, 2005, through September 30, 2010. For each calendar year, we summarized the characteristics of patients reported for the measure, including the number and percentage in each group, the median time to primary percutaneous coronary intervention, and the percentage with time to primary percutaneous coronary intervention within 75 minutes and within 90 minutes. Door-to-balloon time declined from a median of 96 minutes in the year ending December 31, 2005, to a median of 64 minutes in the 3 quarters ending September 30, 2010. There were corresponding increases in the percentage of patients who had times <90 minutes (44.2% to 91.4%) and <75 minutes (27.3% to 70.4%). The declines in median times were greatest among groups that had the highest median times during the first period: patients >75 years of age (median decline, 38 minutes), women (35 minutes), and blacks (42 minutes).
  
  
  CONCLUSIONS
  National progress has been achieved in the timeliness of treatment of patients with ST-segment-elevation myocardial infarction who undergo primary percutaneous coronary intervention.
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, 1 Church St, Ste 200, New Haven, CT 06510, USA. harlan.krumholz@yale.edu
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
authors.forename: Jeph
authors.initials: J
authors.lastname: Herrin
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Miller
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Drye
authors.forename: Shari M
authors.initials: SM
authors.lastname: Ling
authors.forename: Lein F
authors.initials: LF
authors.lastname: Han
authors.forename: Michael T
authors.initials: MT
authors.lastname: Rapp
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Bradley
authors.forename: Brahmajee K
authors.initials: BK
authors.lastname: Nallamothu
authors.forename: Wato
authors.initials: W
authors.lastname: Nsa
authors.forename: Dale W
authors.initials: DW
authors.lastname: Bratzler
authors.forename: Jeptha P
authors.initials: JP
authors.lastname: Curtis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D012042:Registries / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States; D055815:Young Adult