Effects of Door-to-Balloon Times on Outcomes in Taiwanese Patients Receiving Primary Percutaneous Coronary Intervention: A Report of Taiwan Acute Coronary Syndrome Full Spectrum Registry.
OBJECTIVE
The impact of door-to-balloon (DTB) time on patient outcomes is unclear in a Taiwanese population receiving primary percutaneous coronary intervention (PCI). The study aimed to investigate the relationship between stratified DTB times and outcomes through analysis of the database from the Taiwan acute coronary syndrome full spectrum registry.


METHODS
Relevant data were collected from case report forms of patients receiving primary PCI who were categorized as group 1, 2, 3, and 4 according to the DTB time < 45, 45-90, 91-135, and > 135 minutes, respectively. The differences were analyzed by using ANOVA and Kaplan-Meier analyses.


RESULTS
There were significant variations in DTB times at baseline, which included patients salvaged at centers, patients with prior cardiovascular disease, and those patients with different coronary artery flows (p < 0.01) separated into 4 groups (n = 189, 443, 299, and 401, respectively). The in-hospital adverse event rates were identical among the 4 groups except for a higher rate of acute renal failure and a longer hospital stay observed in group 4 (p < 0.01). The results showed no decrease in the incidences of repeated revascularization, major adverse cardiac event, or cardiovascular composite at 1 year in group 1.


CONCLUSIONS
This study suggested that the DTB time is not a good determinant for outcomes in Taiwanese patients receiving primary PCI.


BACKGROUND
Acute myocardial infarction; Cardiovascular outcome; Door-to-balloon time; Myocardial ischemia; Percutaneous coronary intervention.
Cardiovascular Center, Kaohsiung Veterans General Hospital; ; Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung; ; School of Medicine, National Yang-Ming University; ; Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei;
Chi-Cheng
CC
Lai
Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung;
Kuan-Cheng
KC
Chang
Division of Cardiology, Cardiovascular Center, Far Eastern Memorial Hospital, Taipei;
Pen-Chih
PC
Liao
Cardiovascular Department, Chang-Gung Memorial Hospital, Taoyuan;
Chia-Tung
CT
Wu
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Faculty of Medicine, College of Medicine, Kaohsiung, Medical University;
Wen-Ter
WT
Lai
Cardiovascular Department, Chang-Gung Memorial Hospital, Taoyuan; ; Kaohsiung Chang Gung Memorial Hospital, Kaohsiung;
Chiung-Jen
CJ
Wu
Division of Biostatistics, Institute of Public Health, National Yang-Ming University, Taipei;
Shu-Chen
SC
Chang
Cardiovascular Center, Kaohsiung Veterans General Hospital; ; College of Health and Nursing, MeiHo University, Pingtung, Taiwan.
Guang-Yuan
GY
Mar