Zahidi Muzaffar Ali, Iqbal Sadia, Anjum Muhammad, Anber Nabila, Iqbal Minahil
Punjab Institute of Cardiology (PIC), Lahore, Pakistan.
Gujranwala Medical College, Gujranwala, Pakistan.
Catheter Cardiovasc Interv. 2025 Jul;106(1):263-268. doi: 10.1002/ccd.31541. Epub 2025 Apr 17.
Timely primary percutaneous coronary intervention (PCI) is crucial for optimal outcomes in STEMI patients, with guidelines recommending door-to-balloon time (DTB) of less than 90 min. Reducing DTB times may improve clinical outcomes, but the necessity of further reductions is debated.
Our study investigates the in-hospital outcomes of Acute STEMI patients with DTB of less than 60 min versus 60 or more minutes, aiming to determine whether further reducing DTB times is necessary.
A single-center prospective observational study was conducted from March 1 to September 30, 2023. The study included patients presenting with acute STEMI who underwent primary PCI within the specified time frame. Statistical analysis was performed using SPSS Version 20.0, with descriptive statistics and inferential tests (chi-square, independent sample t-test) used to analyse the data, considering a p < 0.05 as statistically significant.
The study enrolled a total of 531 patients with Group-I (< 60 min) having 262 patients, and Group-II (>60 min) with 269 patients. The mean age was 52 years (90% males). Comorbidities, such as diabetes mellitus, smoking, hypertension, and family history of CAD, were similarly distributed between groups. In terms of outcomes, Group-I had better results, with 128 patients achieving TIMI-III flow, compared to 113 in Group-II. Group-I also had lower rates of myocardial infarction (0 vs. 2), shock (7 vs. 8), and heart failure (2 vs. 5). Notably, the mortality rate was 0 in Group-I, compared to 5 in Group-II, however all complications in terms of death or morbidity were statistically non-significant in both groups. Other outcomes, such as bleeding events, hematoma, and cerebrovascular accidents, were also low and similar between groups.
The results showed that both groups had similar patient characteristics, including age, gender, and comorbidities, with adverse events, such as acute stent thrombosis, myocardial infarction, and mortality, were generally low and similar between groups.
及时进行直接经皮冠状动脉介入治疗（PCI）对于ST段抬高型心肌梗死（STEMI）患者获得最佳治疗效果至关重要，指南建议门球时间（DTB）少于90分钟。缩短DTB时间可能会改善临床结局，但进一步缩短时间的必要性仍存在争议。
我们的研究调查了DTB少于60分钟与60分钟及以上的急性STEMI患者的院内结局，旨在确定是否有必要进一步缩短DTB时间。
于2023年3月1日至9月30日进行了一项单中心前瞻性观察研究。该研究纳入了在特定时间范围内接受直接PCI的急性STEMI患者。使用SPSS 20.0进行统计分析，采用描述性统计和推断性检验（卡方检验、独立样本t检验）分析数据，将p<0.05视为具有统计学意义。
该研究共纳入531例患者，其中第一组（<60分钟）有262例患者，第二组（>60分钟）有269例患者。平均年龄为52岁（90%为男性）。糖尿病、吸烟、高血压和CAD家族史等合并症在两组间分布相似。在结局方面，第一组结果更好，128例患者达到TIMI-III血流，而第二组为113例。第一组的心肌梗死发生率（0例 vs. 2例）、休克发生率（7例 vs. 8例）和心力衰竭发生率（2例 vs. 5例）也更低。值得注意的是，第一组的死亡率为0，而第二组为5例，然而两组在死亡或发病方面的所有并发症在统计学上均无显著差异。其他结局，如出血事件、血肿和脑血管意外，发生率也较低且两组相似。
结果表明，两组患者特征相似，包括年龄、性别和合并症，急性支架血栓形成、心肌梗死和死亡率等不良事件总体发生率较低且两组相似。
