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Few studies have focused on the change of prognostic factors after improving door-to-balloon time. The aim of this study was to explore the change of prognostic factors and to identify the important predictors of mortality after improving door-to-balloon time.
From January 2005 to December 2014, 1751 patients experienced ST-segment elevation myocardial infarction and received primary percutaneous intervention in our hospital. During a 10-year period, the patients were divided into two groups (group 1 and group 2) according to the time period. Since mid-2009, shortening door-to-balloon time has been an important concern of health care. As a result of targeted efforts, as of January 2010, door-to-balloon time shortened significantly. In our study, a total 853 patients were in group 1, and a total 898 patients were in group 2 according to the time period.
The average age of all patients was 61.17 ± 12.86 years, and 82.6% were male. The incidence of major adverse cardiac cerebral events (26.7% vs. 23.2%; p=0.120), the incidence of cardiovascular mortality (9.3% vs. 8.8%; p=0.741), and the incidence of all-cause mortality (12.6% vs.12.2%; p=798) were similar between the two groups. The incidence of target vessel revascularization significantly decreased in group 2 (17.8% vs. 12.6%;p=0.008). However, the incidence of stroke increased in group 2 (1.8% vs. 3.6%; p=0.034).
Improving door-to-balloon time could not improve 1-year cardiovascular mortality rates, whether low-risk or high-risk patients. We need to focus on chest pain-to-door time to decrease ischemic time and the severity of a disease.