Achieving rapid reperfusion with primary percutaneous coronary intervention remains a challenge: insights from American Heart Association's Get With the Guidelines program.
BACKGROUND: The speed of reperfusion (door-to-balloon [D2B] time) is a well established performance metric for patients with ST-elevation myocardial infarction. Although preferably D2B times should be or=65 years, 27% female, and 17% nonwhite). The overall median D2B time was 96 minutes (interquartile range [IQR] 69-140 minutes). Only 44.8% of cases had D2B or=65 years (103 [IQR 74-153] vs 93 [IQR 67-133] minutes), women (103 [IQR 73-154] vs 94 [IQR 68-135] minutes), and minorities (108 [IQR 77-162] vs 95 [IQR 68-136] minutes) had significantly longer median D2B times. These subgroup disparities in the D2B persisted over the study period as compared with their peers. CONCLUSION: The median D2B times with primary PCI have improved modestly in hospitals participating in the American Heart Association Get With the Guidelines program over the last few years but remain below ideal levels. The D2B times are particularly delayed in the elderly people, women, and minority populations; an issue that has persisted over time. These results highlight the ongoing need for national myocardial infarction quality improvement initiatives.
Mehta, RH; Bufalino, VJ; Pan, W; Hernandez, AF; Cannon, CP; Fonarow, GC; Peterson, ED; American Heart Association Get With the Guidelines Investigators,
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