Relationship between time to treatment and mortality among patients undergoing primary percutaneous coronary intervention according to Korea Acute Myocardial Infarction Registry

other Korea Acute Myocardial Infarction Registry Investigators

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background Despite large reductions in door-to-balloon times over the period, several studies from regional and national data showed that annual mortality rates were not decreased among patients who underwent primary percutaneous coronary intervention (PCI). However, these studies mostly focused on door-to-balloon time, and there was no consideration of total ischemic time in a trend of mortality. The aim of this study was to assess the annual trend between time to treatment and 1-month mortality among patients undergoing primary PCI. Methods and results The study population consisted of 8040 patients who underwent primary PCI at hospitals participating in the nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) between January 2008 and December 2011. The primary end point of this study was 1-month all-cause mortality, and time to treatment (door-to-balloon time, symptom-to-balloon time). One-month death occurred in 452 patients (5.6%) from 2008 to 2011. Additional reductions in door-to-balloon time were not translated into parallel reductions in mortality rate and total ischemic time. After adjustment using clinical risk, shorter total ischemic time was an independent predictor of 1-month mortality [adjusted odds ratio (OR) 0.78, 95% confidential interval (CI) 0.62–0.99, p = 0.04]. Total ischemic time could be reduced by using emergency medical services. Conclusion Despite improvements in door-to-balloon time, no parallel reductions in mortality rate and total ischemic time were observed. Total ischemic time was associated with mortality. The present study suggests that additional efforts are needed to shorten total ischemic time including patient and pre-hospital systemic delay for better prognosis after primary PCI.

Original languageEnglish
Pages (from-to)377-382
Number of pages6
JournalJournal of Cardiology
Volume69
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Percutaneous Coronary Intervention
Korea
Registries
Myocardial Infarction
Mortality
Therapeutics
Emergency Medical Services

Keywords

  • Door-to-balloon time
  • Myocardial infarction
  • Primary percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relationship between time to treatment and mortality among patients undergoing primary percutaneous coronary intervention according to Korea Acute Myocardial Infarction Registry. / other Korea Acute Myocardial Infarction Registry Investigators.

In: Journal of Cardiology, Vol. 69, No. 1, 01.01.2017, p. 377-382.

Research output: Contribution to journalArticle

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abstract = "Background Despite large reductions in door-to-balloon times over the period, several studies from regional and national data showed that annual mortality rates were not decreased among patients who underwent primary percutaneous coronary intervention (PCI). However, these studies mostly focused on door-to-balloon time, and there was no consideration of total ischemic time in a trend of mortality. The aim of this study was to assess the annual trend between time to treatment and 1-month mortality among patients undergoing primary PCI. Methods and results The study population consisted of 8040 patients who underwent primary PCI at hospitals participating in the nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) between January 2008 and December 2011. The primary end point of this study was 1-month all-cause mortality, and time to treatment (door-to-balloon time, symptom-to-balloon time). One-month death occurred in 452 patients (5.6{\%}) from 2008 to 2011. Additional reductions in door-to-balloon time were not translated into parallel reductions in mortality rate and total ischemic time. After adjustment using clinical risk, shorter total ischemic time was an independent predictor of 1-month mortality [adjusted odds ratio (OR) 0.78, 95{\%} confidential interval (CI) 0.62–0.99, p = 0.04]. Total ischemic time could be reduced by using emergency medical services. Conclusion Despite improvements in door-to-balloon time, no parallel reductions in mortality rate and total ischemic time were observed. Total ischemic time was associated with mortality. The present study suggests that additional efforts are needed to shorten total ischemic time including patient and pre-hospital systemic delay for better prognosis after primary PCI.",
keywords = "Door-to-balloon time, Myocardial infarction, Primary percutaneous coronary intervention",
author = "{other Korea Acute Myocardial Infarction Registry Investigators} and Kim, {Hyun Kuk} and Jeong, {Myung Ho} and Youngkeun Ahn and Chae, {Shung Chull} and Kim, {Young Jo} and Hur, {Seung Ho} and Seong, {In Whan} and Hong, {Taek Jong} and Choi, {Dong Hoon} and Cho, {Myeong Chan} and Kim, {Chong Jin} and Seung, {Ki Bae} and Jang, {Yang Soo} and Seung-Woon Rha and Bae, {Jang Ho} and Kim, {Sung Soo} and Park, {Seung Jung}",
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T1 - Relationship between time to treatment and mortality among patients undergoing primary percutaneous coronary intervention according to Korea Acute Myocardial Infarction Registry

AU - other Korea Acute Myocardial Infarction Registry Investigators

AU - Kim, Hyun Kuk

AU - Jeong, Myung Ho

AU - Ahn, Youngkeun

AU - Chae, Shung Chull

AU - Kim, Young Jo

AU - Hur, Seung Ho

AU - Seong, In Whan

AU - Hong, Taek Jong

AU - Choi, Dong Hoon

AU - Cho, Myeong Chan

AU - Kim, Chong Jin

AU - Seung, Ki Bae

AU - Jang, Yang Soo

AU - Rha, Seung-Woon

AU - Bae, Jang Ho

AU - Kim, Sung Soo

AU - Park, Seung Jung

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N2 - Background Despite large reductions in door-to-balloon times over the period, several studies from regional and national data showed that annual mortality rates were not decreased among patients who underwent primary percutaneous coronary intervention (PCI). However, these studies mostly focused on door-to-balloon time, and there was no consideration of total ischemic time in a trend of mortality. The aim of this study was to assess the annual trend between time to treatment and 1-month mortality among patients undergoing primary PCI. Methods and results The study population consisted of 8040 patients who underwent primary PCI at hospitals participating in the nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) between January 2008 and December 2011. The primary end point of this study was 1-month all-cause mortality, and time to treatment (door-to-balloon time, symptom-to-balloon time). One-month death occurred in 452 patients (5.6%) from 2008 to 2011. Additional reductions in door-to-balloon time were not translated into parallel reductions in mortality rate and total ischemic time. After adjustment using clinical risk, shorter total ischemic time was an independent predictor of 1-month mortality [adjusted odds ratio (OR) 0.78, 95% confidential interval (CI) 0.62–0.99, p = 0.04]. Total ischemic time could be reduced by using emergency medical services. Conclusion Despite improvements in door-to-balloon time, no parallel reductions in mortality rate and total ischemic time were observed. Total ischemic time was associated with mortality. The present study suggests that additional efforts are needed to shorten total ischemic time including patient and pre-hospital systemic delay for better prognosis after primary PCI.

AB - Background Despite large reductions in door-to-balloon times over the period, several studies from regional and national data showed that annual mortality rates were not decreased among patients who underwent primary percutaneous coronary intervention (PCI). However, these studies mostly focused on door-to-balloon time, and there was no consideration of total ischemic time in a trend of mortality. The aim of this study was to assess the annual trend between time to treatment and 1-month mortality among patients undergoing primary PCI. Methods and results The study population consisted of 8040 patients who underwent primary PCI at hospitals participating in the nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) between January 2008 and December 2011. The primary end point of this study was 1-month all-cause mortality, and time to treatment (door-to-balloon time, symptom-to-balloon time). One-month death occurred in 452 patients (5.6%) from 2008 to 2011. Additional reductions in door-to-balloon time were not translated into parallel reductions in mortality rate and total ischemic time. After adjustment using clinical risk, shorter total ischemic time was an independent predictor of 1-month mortality [adjusted odds ratio (OR) 0.78, 95% confidential interval (CI) 0.62–0.99, p = 0.04]. Total ischemic time could be reduced by using emergency medical services. Conclusion Despite improvements in door-to-balloon time, no parallel reductions in mortality rate and total ischemic time were observed. Total ischemic time was associated with mortality. The present study suggests that additional efforts are needed to shorten total ischemic time including patient and pre-hospital systemic delay for better prognosis after primary PCI.

KW - Door-to-balloon time

KW - Myocardial infarction

KW - Primary percutaneous coronary intervention

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