Interventional cardiologists are held accountable for delay in the door-to-balloon
time (DBT) for patients undergoing primary percutaneous coronary intervention in the
setting of ST-elevation myocardial infarction (STEMI) even though in the chain of
STEMI activation, the interventional cardiologist is the last person that needs to
be available to start angiography. The goal of our study is to conduct a thorough
analysis of the DBT data to assess time delays by randomly evaluating two consecutive
years at the University of Arizona Medical Center (UAMC). We evaluated all available
DBT data for STEMIs occurring in the fiscal years of 2011 and 2012 at the UAMC and
calculated the time needed for the cardiologist to start the procedure after the patient
was ready in the cardiac catheterization laboratory called time to start the procedure
(TSP) in addition to other time intervals. Mean TSP time was 4 minutes and 24 seconds,
one of the shortest time delays in the chain of STEMI activation and DBT. The median
TSP delay was 3 minutes. The longest delay interval was the STEMI team's arrival to
with a mean of 17 minutes and 38 seconds. Our data are the first to evaluate delays
related to DBT revealing the least delay occurring due to the late arrival of Interventional
cardiologists. Our data emphasizes the importance of performing a detailed time analysis
of the DBT.
Keywords
STEMI - timing - door-to-balloon time - primary angioplasty - primary stenting - primary
PCI - coronary revascularization
