The development of door-to-angiography time in the last 14 years for patients with acute ST-elevation myocardial infarction treated with primary coronary intervention: Determinants and outcome. Results from the MITRAplus and OPTAMI registry

Abstract

Aim of the study: To examine the development of door-to- angiography time (DTA) and to evaluate the impact of door-to-angiography time in patients with ST-elevation myocardial infarction (STEMI) on hospital and one-year mortality.

Methods and Results: From 1994 to 2008, 5078 patients (pts) and known DTA with acute ST-elevation myocardial infarction were enrolled into the MITRAplus and OPTAMI registry in Germany. Our data showed a reduction of the door-to- angiography time from 80 min to 64 min in the last 14 years (P < 0.001). Over 80% of patients received an angiography less than two hours after admission. The main predictor of a shorter door-to-balloon time was a hypotension with a blood pressure lower than 100 mmHg (OR 1.46, 95%CI: 1.08–1.91). Whereas a history of prior myocardial infarction (OR 0.61, 95%CI: 0.45–0.84), a previous coronary bypass grafting (OR 0.55, 95%CI: 0.33–0.91), age older than 75 years (OR 0.78, 95%CI: 0.62–0.99) and a pre-hospital delay more than three hours (OR 0.78, 95%CI: 0.66–0.93) were independent predictors for a longer of the door-to-balloon time. In the multivariate regression analysis no influence was detected of door-to-angiography time on hospital or one-year mortality.

Conclusion: The DTA decreased in the last 14 years and is actually very short in Germany. We indentified predictors of a longer door-to-angiography time in clinical practice. Given the overall short in-hospital delay, the observed door-to-angiography time did not have influence on hospital and mid term mortality.

Keywords::

• Door-to-balloon time
• myocardial infarction
• outcome

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.