The influence of symptom to balloon time in ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

¹Department of Emergency Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
²Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea

Correspondence

Daesup Lee ,Tel: 055-360-2143, Fax: 055-360-2173, Email: kurt91@hanmail.net,

Received: June 13, 2019; Revised: September 18, 2019 Accepted: October 30, 2019. Published online: December 31, 2019.

ABSTRACT

Objective:
The current guidelines for the treatment of ST-segment elevation myocardial infarction (STEMI) recommends early reperfusion with a door to balloon (DTB) time of 90 minutes or less in patients undergoing primary percutaneous coronary intervention (PPCI). Therefore, the focus of most studies has been the DTB time. On the other hand, the ischemic time is related to the symptom to balloon (STB) time rather than the DTB time. This study examined the clinical effects of the STB time as well as the social and clinical factors affecting the STB time in STEMI patients.
Method:
This study analyzed 286 patients diagnosed with STEMI from December 2008 to December 2016. The STB time (≤4 hours and >4 hours, ≤12 hours, and >12 hours) in the groups was compared. The mortality and ejection fraction were investigated. In addition, the characteristics of patients and socioeconomic factors affecting STB were analyzed.
Results:
The SBT time is inversely associated with the ejection fraction (R=-0.126, P=0.033), and the ejection fraction of the ≤12 hours group was higher than that of the >12 hours group (54% vs. 50%, P=0.047). On the other hand, there was no significant difference in mortality between the two groups (3.26% vs. 4.84%, P=0.506). In multivariate analysis, the variable related to SBT was only typical chest pain (adjusted odd ratio, 1.931; 95% confidential interval, 1.014-3.792; P=0.045).
Conclusion:
The results of the study support the prognostic value of SBT in STEMI undergoing PPCI. Therefore, efforts should be made to shorten the STB time.

Key words: Symptom to balloon time; Segment elevation myocardial infarction; Percutaneous coronary intervention