eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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abstract:
Original paper

The effect of emergency department delay time on all-cause mortality of ST-segment elevation myocardial infarction patients who underwent primary percutaneous coronary intervention: does every minute affect mortality?

Serdar Söner
1
,
Ercan Taştan
1
,
Metin Okşul
1
,
Adnan D. Cömert
1
,
Ümit İnci
1
,
Cansu Öztürk
1
,
Mahsum Altunbaş
1
,
Rohat Tüzün
1
,
Murat Çap
1
,
Tuncay Güzel
1
,
İsmail Tatlı
1
,
Erkan Baysal
1

  1. Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
Adv Interv Cardiol
DOI: https://doi.org/10.5114/aic.2024.145173
Online publish date: 2024/11/20
View full text Get citation
 
Introduction:
The most effective therapy for ST-segment elevation myocardial infarction (STEMI) is immediate primary percutaneous coronary intervention (pPCI).

Aim:
We planned this study to evaluate the effect of emergency department delay time (EDDT) on in-hospital and 1-year all-cause mortality in STEMI patients who underwent pPCI.

Material and methods:
Between October 2016 and May 2021, we examined 890 consecutive STEMI patients who had pPCI at our institution within 12 h of the onset of symptoms. The clinical endpoint of this study was in-hospital and 1-year all-cause mortality.

Results:
The cohort mostly comprised men (690 [77.5]), and their mean age was 60.7 ±13.5 years. The median EDDT was 23 (15–35) min, sheath-to-balloon (STB) time was 10 (7–13) min, and door-to-balloon (DTB) time was 34 (25–48) min. In multivariable logistic regression analysis EDDT (OR = 0.994; CI = 0.972–1.017; p = 0.611) was not a predictor for in-hospital mortality. In the multivariable logistic regression analysis, EDDT (HR = 1.011, CI = 1.002–1.021, p = 0.022), age (HR = 1.044, CI = 1.019–1.068, p < 0.001), left ventricle ejection fraction (HR = 0.957, CI = 0.931–0.988, p = 0.003), and glomerular filtration rate (HR = 0.982, CI = 0.966–0.997, p = 0.016) were the independent predictors of 1-year all-cause death across all causes.

Conclusions:
We found that EDDT was an independent predictor among all causes for 1-year mortality in STEMI patients who underwent pPCI but not in-hospital mortality. Reducing the time spent in the emergency department as much as possible may reduce mortality rates.

keywords:

primary percutaneous coronary intervention, ST segment elevation myocardial infarction, delay time, door-to-balloon time
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