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Studies have shown that several factors influence the door-to-balloon time (DTBT) in patients with STEMI. We identified the factors that significantly prolonged the DTBT in an underdeveloped area of China.
We analyzed the DTBT and its components from January 2008 to December 2010 in 301 consecutive patients presenting with STEMI in our hospital. We determined which factors significantly prolonged the DTBT.
The median DTBT of all patients was 149±78 min. The group was divided by the DTBT into two: ≤120 min and >120 min. The median DTBT of the two groups was 87±29 min and 201±68 min, respectively (P=0.000). In the ≤120 min group, more patients (68.1%) presented to our hospital during working hours (P=0.000) whereas in the >120 min group more patients (63.2%) presented out of hours (P=0.000). More patients (49.3%) presented when the interventionist was on site (P=0.000) in the ≤120 min group. Factors that significantly lengthened the DTBT were the time: for consultation by the cardiologist (P=0.000); for explaining the patient's condition to the family (P=0.000): when the interventionist was off-duty (P=0.000); of having a slight chest pain (P=0.000); of presentation out-of-hours for the Catheterization Laboratory (P=0.000).
In the underdeveloped area of China, the time of consultation by the cardiologist and explaining the patient's condition to the family accounted for most of the delay in reperfusion. Several measures should be taken involving asking ED physicians to awake CL directly, ensuring that attending physicians know the importance of early reperfusion, increasing public awareness of the importance of PCI, and increasing the numbers of interventionists qualified to carry out primary PCI to shorten the DTBT.
[keywords] STEMI; door-to-balloon time; China
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Pre-Hospital ECG and Transfer: Time Is Myocardium
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1212-179
- 2013 American College of Cardiology Foundation