ASSOCIATION BETWEEN DOOR-TO-BALLOON TIME AND IN-HOSPITAL MORTALITY IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Background: ST-Elevation Myocardial Infarction (STEMI) is a potentially fatal emergency involving the heart, and it requires immediate reperfusion therapy to deliver blood to the heart and minimize the amount of damage to the heart. The most appropriate form of treatment of STEMI when prompt is Primary Percutaneous Coronary Intervention (PPCI). One such quality measure used in the management of STEMI is Door to Balloon (D2B) time, the time between the arrival of the patient at the hospital and the first balloon inflation during PPCI. The prolonged D2B time is also associated with the poor clinical prognosis and mortality. The aim of this paper was to determine the correlation between the in-hospital mortality and the door-to-balloon time of patients with STEMI who underwent primary PCI.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: The research was carried out in Punjab Institute of Cardiology, Lahore from January 2023 to July 2023.

Methodology: Non-probability consecutive sampling resulted in the determination of 250 patients who had been diagnosed with STEMI and were receiving primary PCI. Patients who were already thrombolysed previously, patients who presented with cardiogenic shock and those who did not have complete records were excluded. The door-to-balloon time involved in the calculation was calculated through the period between the arrival of the hospital and first balloon inflation and the categorization of the patients made it to include two groups; 90 minutes or less and above 90 minutes. WHO formula calculator, sample size was employed in the calculation of sample size, keeping in mind a level of confidence of 95 percent, and projected proportion which is based on past studies. Analysis of data was performed using SPSS version 26 and Chi-square test was applied.

Results: Out of 250 patients, 155 (62% to 95) patients in the cohort had a D2B time of 90 minutes or less and 95 (38) patients of time above 90 minutes, respectively. The overall in-hospital mortality stood at 20 (8%). There was greater mortality in the patients with D2B time greater than 90 minutes than those with D2B time less than 90 minutes (p<0.05).

Conclusion: Conclusion Long door-to-balloon time is linked significantly with in-hospital mortality in STEMI patients who receive primary PCI. Keywords Primary Keywords STEMI, Door-to-Balloon Time, Primary PCI, In-Hospital Mortality, Acute Myocardial Infarction, Reperfusion Therapy, Cardiology, Emergency Care.