Influence of 20-Year Reduction in Door-to-Balloon Times on Outcomes of Patients with Anterior ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Prospective Study

Authors

  • Vikas Kumar Ex HOD Cardiology & Director Cathlab, Department of Cardiology, J.V.N. Heart Hospital, Patna, Bihar, India

Keywords:

Outcomes, Primary PCI, Anterior STEMI, Ischemic heart disease

Abstract

Background: The biggest cause of death worldwide is cardiovascular disease. This 20-year study at the tertiary care center examined how reduced door-to-balloon timings (DBT) affected patient outcomes for anterior STEMI (ST-elevation myocardial infarction) patients from 2003 to 2022. This study aimed to examine clinical features, hospitalization, mortality, and DBT's effect on anterior STEMI patients' long-term survival over two decades.

Methods: In the study 829 anterior STEMI patients were examined who received PPCI within 12 hours of presentation. Patient data were divided into four five-year quartiles (2003-2007, 2008-2012, 2013-2017, and 2018-2022). Analyses included demographic, clinical, and mortality data. Age, hypertension, smoking status, obesity, hospital stay, diabetes, and DBT were important. Multivariate analysis accounted for gender, age, comorbidities, clinical shock, ejection fraction, mitral regurgitation.

Results: The study found a substantial drop in patient age (63.4 to 60 yrs, p<0.01), with hypertension, smoking, and obesity prevalence increasing across all quartiles. Diabetes prevalence remained unchanged. Median hospital stays decreased (7 to 4.6 days, p<0.01), and median DBT fell significantly (216 to 37 minutes, p<0.01). Both 30-day and 1-year mortality improved (p=0.01), from 13.4% to 6.8% and 19.5% to 12.9%, respectively. Three-year mortality fell from 24.3% to 15.5% (p=0.02). Compared to DBT < 60 minutes, shorter DBT was related with reduced mortality over time after controlling for numerous variables.

Conclusion: Long-term prognosis for anterior STEMI patients at our center have improved over the previous two decades. DBT decreased with these changes. This study emphasizes the need to optimize door-to-balloon timeframes for anterior STEMI care and prompt intervention.

Recommendation: Healthcare providers should target anterior STEMI door-to-balloon time reduction based on this study. To improve results in this patient population, smoking, hypertension, and obesity should be addressed. Additional research is needed to improve anterior STEMI patient treatment and care.

Published

2024-03-31

How to Cite

Kumar, V. . (2024). Influence of 20-Year Reduction in Door-to-Balloon Times on Outcomes of Patients with Anterior ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Prospective Study. Student’s Journal of Health Research Africa, 5(3). Retrieved from https://sjhresearchafrica.org/index.php/public-html/article/view/1028

Issue

Section

Section of General Medicine Research