IMPACT OF DOOR-TO-BALLOON TIME ON CLINICAL OUTCOME OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION AMONG THE PATIENTS OF STEMI AT A LARGE TERTIARY CARE HOSPITAL

Abstract

Objective: There is inadequate information to conclude that patients with ST-elevation myocardial infarction (STEMI) death at a significantly higher rate when there is a slight incremental increase in door-to-balloon (D2B) time.

 Methods: The cross sectional study design was used to collect data, total 577 patients were enrolled and research was carried out in the department of Cardiology, Punjab Institute of Cardiology, Lahore for a duration of six months. Current study outcome was in-hospital mortality and complications. The principal independent variable was door-to-balloon time, which is the time from hospital arrival to balloon inflation

Results: The mean age of the cases in this study in Group A is 52.29 ± 11.11 and 51.65 ± 13.09 in Group B. There were 344 (88.9%) male and 43 (11.1%) females in Group A similarly, 164 (86.3%) male and 26 (13.7%). There were 128 (33.1%) diabetics, 184 (47.5%) hypertensive, 7 (1.8%) hyperlipidemia patients, 202 (52.2%) smokers and 141 (36.4%) patients with family history of premature coronary artery disease found in Group A, similarly, 65 (34.2%) diabetic, 88 (46.3%) hypertensive, 9 (4.7%) hyperlipidemia patients, 92 (48.4%) smokers and 75 (39.5%) patients with family history of premature coronary artery disease found in Group B. 1 (0.3%) in Group A and 1 (0.5%) in Group B use illicit drug in this study. In Group A 12 (3.1%) patients found with prior PCI, 0 (0%) with prior CABG, and 14 (3.6%) with prior MI, similarly in Group B 16 (8.4%) patients found with prior PCI, 1 (0.5%) with prior CABG and 7 (3.7%) with prior MI in this study. The comparison of outcomes i.e., MI, cardiogenic shock, heart failure, CVA/Stroke, hemorrhagic, dissection, death, stent thrombosis, bleeding events within 72 hours, temponade, new requirement for dialysis, heamotoma, no flow reflow, perforation, and other vascular complications showed that there is no significant difference between both groups as p-values found insignificant i.e., 0.321, 0.350, 0.073, 0.537, 0.100, 0.483, 0.216, 0.321, 0.607, 1.00, 1.00, 0.668, 0.483, 1.00 and 0.483 respectively. (Table 2)

Conclusions: Treatment for acute myocardial infarction requires a door-to-balloon time, while there has been a notable improvement in door-to-balloon timeframes for patients receiving primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction, the rate of in-hospital mortality has remained essentially the same. These statistics indicate that further measures are required to decrease the number of deaths that occur within the hospital among this specific group of individuals.