Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis
Objective: This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers. Methods: We conducted a systematic review and meta-analysis of prospec...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
BMJ Publishing Group
2018
|
| Online Access: | http://hdl.handle.net/20.500.11937/74628 |
| _version_ | 1848763328210403328 |
|---|---|
| author | Foo, C. Bonsu, K. Nallamothu, B. Reid, Christopher Dhippayom, T. Reidpath, D. Chaiyakunapruk, N. |
| author_facet | Foo, C. Bonsu, K. Nallamothu, B. Reid, Christopher Dhippayom, T. Reidpath, D. Chaiyakunapruk, N. |
| author_sort | Foo, C. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers. Methods: We conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure. Results: 32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time-risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran's Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays. Conclusion: Longer door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time-risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA. Clinical trial registration PROSPERO (CRD42015026069). |
| first_indexed | 2025-11-14T11:01:43Z |
| format | Journal Article |
| id | curtin-20.500.11937-74628 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T11:01:43Z |
| publishDate | 2018 |
| publisher | BMJ Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-746282019-03-13T06:39:19Z Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis Foo, C. Bonsu, K. Nallamothu, B. Reid, Christopher Dhippayom, T. Reidpath, D. Chaiyakunapruk, N. Objective: This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers. Methods: We conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure. Results: 32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time-risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran's Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays. Conclusion: Longer door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time-risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA. Clinical trial registration PROSPERO (CRD42015026069). 2018 Journal Article http://hdl.handle.net/20.500.11937/74628 10.1136/heartjnl-2017-312517 BMJ Publishing Group restricted |
| spellingShingle | Foo, C. Bonsu, K. Nallamothu, B. Reid, Christopher Dhippayom, T. Reidpath, D. Chaiyakunapruk, N. Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis |
| title | Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis |
| title_full | Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis |
| title_fullStr | Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis |
| title_full_unstemmed | Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis |
| title_short | Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: A meta-analysis |
| title_sort | coronary intervention door-to-balloon time and outcomes in st-elevation myocardial infarction: a meta-analysis |
| url | http://hdl.handle.net/20.500.11937/74628 |