Impact of Door-to-Balloon Time on Mortality Outcomes in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention: A Multicenter South Asian Study

doi:N/A

Bangaldesh Journal of Cardivascular Medicine

2024, Volume 2, Issue 3 : 1-5

Research Article

Impact of Door-to-Balloon Time on Mortality Outcomes in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention: A Multicenter South Asian Study

Mohammad A. Rahman

Priya K. Sharma

Ravi Perera

Ahmed S. Hossain

⁴

Department of Interventional Cardiology, Bangladesh Institute of Cardiovascular Sciences, Dhaka, Bangladesh

National Heart Research Centre, New Delhi, India

Colombo Heart and Vascular Institute, Colombo, Sri Lanka

⁴

South Asian Cardiovascular Research Center, Chattogram, Bangladesh

Abstract

Background

Timely reperfusion is the cornerstone of ST-Elevation Myocardial Infarction (STEMI) management. Door-to-balloon (D2B) time, defined as the interval from hospital arrival to first balloon inflation during primary Percutaneous Coronary Intervention (PCI), remains a critical quality indicator in contemporary cardiovascular care.

Objective

To evaluate the impact of door-to-balloon time on mortality and clinical outcomes among STEMI patients undergoing primary PCI.

Methods

A prospective multicenter observational study was conducted involving 2,150 STEMI patients treated with primary PCI across 12 tertiary cardiac centers in South Asia between January 2021 and December 2024. Patients were categorized into three groups according to D2B time: <90 minutes, 90–120 minutes, and >120 minutes. Clinical outcomes including mortality, reinfarction, heart failure, stroke, and major adverse cardiovascular events (MACE) were analyzed.

Results

Overall procedural success was 94.7%. Thirty-day mortality increased progressively with longer D2B times (3.1%, 5.8%, and 10.4%, respectively; p<0.001). Patients with D2B time <90 minutes demonstrated significantly lower rates of heart failure, cardiogenic shock, and MACE. Multivariate analysis identified prolonged D2B time as an independent predictor of mortality.

Conclusion

Shorter door-to-balloon times significantly improve survival and reduce adverse cardiovascular outcomes among STEMI patients. Efforts to optimize STEMI care pathways and achieve D2B times below 90 minutes should remain a major priority in South Asian healthcare systems.

Keywords

STEMI

Door-to-Balloon Time

Primary PCI

Mortality

Reperfusion Therapy

Acute Myocardial Infarction

South Asia

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