Int J Angiol 2020; 29(01): 027-032
DOI: 10.1055/s-0039-3401046
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

“Door-In to Door-Out” Delay in Patients with Acute ST-Segment Elevation Myocardial Infarction Transferred for Primary Percutaneous Coronary Intervention in a Metropolitan STEMI Network of a Developing Country

Iwan Dakota
1  Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia
,
1  Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia
,
Hananto Andriantoro
1  Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia
,
Isman Firdaus
1  Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia
,
Siska Suridanda Danny
1  Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia
,
Dian Zamroni
1  Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia
,
Basuni Radi
1  Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, West Jakarta, Indonesia
› Author Affiliations
Further Information

Publication History

Publication Date:
27 December 2019 (online)

Abstract

Background

Routine performance measures of primary percutaneous coronary intervention (PCI) within an ST-segment elevation myocardial infarction (STEMI) network are needed to improve care.

Objective

We evaluated the door-in to door-out (DI–DO) delays at the initial hospitals in STEMI patients as a routine performance measure of the metropolitan STEMI network.

Patients and Methods

We retrospectively analyzed the DI–DO time from 1,076 patients with acute STEMI who were transferred by ground ambulance to a primary PCI center for primary PCI between 4 October 2014 and 1 April 2019. Correlation analysis between DI–DO times and total ischemia time was performed using Spearman's test. Logistic regression analyses were used to find variables associated with a longer DI–DO time.

Results

Median DI–DO time was 180 minutes (25th percentile to 75th percentile: 120–252 minutes). DI–DO time showed a positive correlation with total ischemia time (r = 0.4, p < 0.001). The median door-to-device time at the PCI center was 70 minutes (25th percentile to 75th percentile: 58–88 minutes). Multivariate analysis showed that women patients were independently associated with DI–DO time > 120 minutes (odds ratio 1.55, 95% confidence interval 1.03 to 2.33, p = 0.03).

Conclusion

The DI–DO time reported in this study has not reached the guideline recommendation. To improve the overall performance of primary PCI in the region, interventions aimed at improving the DI–DO time at the initial hospitals and specific threat for women patients with STEMI are possibly the best efforts in improving the total ischemia time.

Financial Support

None.