When is door-to-balloon time critical? Analysis from the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) and CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) trials

Journal of the American College of Cardiology
Bruce R BrodieGregg W Stone

Abstract

Our objective was to evaluate the impact of door-to-balloon time (DBT) on mortality depending on clinical risk and time to presentation. DBT affects the mortality rate in ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention, but the impact may vary across subgroups. The CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) and HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trials evaluated stent and antithrombotic therapy in patients undergoing primary percutaneous coronary intervention. We studied the impact of DBT on mortality in 4,548 patients based on time to presentation and clinical risk. The 1-year mortality rate was lower in patients with short versus long DBT (< or = 90 min vs. >90 min, 3.1% vs. 4.3%, p = 0.045). Short DBTs were associated with a lower mortality rate in patients with early presentation (< or = 90 min: 1.9% vs. 3.8%, p = 0.029) but not those with later presentation (>90 min: 4.0% vs. 4.6%, p = 0.47). Short DBTs showed similar trends for a lower mortality rate in high-risk (5.7% vs. 7.4%, p = 0.12) and low-risk (1.1% vs. 1.6%, p = 0.25) patients. Short DBTs had si...Continue Reading

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Citations

May 25, 2011·Journal of Thrombosis and Thrombolysis·Eliano Pio NavareseSilvio Klugmann
Sep 18, 2013·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Xiaoyu YangAnjan K Chakrabarti
Jan 1, 2012·Global Cardiology Science & Practice·Abdurrazzak GehaniMagdi Yacoub
Jan 1, 2013·Global Cardiology Science & Practice·Abdurrazzak Gehani
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Jun 28, 2011·JACC. Cardiovascular Interventions·Bruce R Brodie
Jan 22, 2011·Journal of the American College of Cardiology·Anthony N DeMariaSotirios Tsimikas
Feb 27, 2017·Journal of Vascular Surgery·Madhukar S Patel, Elliot L Chaikof
Nov 10, 2011·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Matthew B KahnStephen B Wheatcroft
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Oct 30, 2021·The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology·Sanam KhowajaMusa Karim

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