J Korean Soc Emerg Med.  2019 Dec;30(6):577-583. 10.0000/jksem.2019.30.6.577.

The influence of symptom to balloon time in ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

• Chun M
• Lee D
• Min MK
• Ryu JH
• Lee KH
• Lee MJ
• Jo YM
• Kim HB
• Wang IJ

• KMID: 2470549
• DOI: http://doi.org/10.0000/jksem.2019.30.6.577

Abstract

OBJECTIVE
The current guidelines for the treatment of ST-segment elevation myocardial infarction (STEMI) recommends early reperfusion with a door to balloon (DTB) time of 90 minutes or less in patients undergoing primary percutaneous coronary intervention (PPCI). Therefore, the focus of most studies has been the DTB time. On the other hand, the ischemic time is related to the symptom to balloon (STB) time rather than the DTB time. This study examined the clinical effects of the STB time as well as the social and clinical factors affecting the STB time in STEMI patients.
METHODS
This study analyzed 286 patients diagnosed with STEMI from December 2008 to December 2016. The STB time (≤4 hours and>4 hours, ≤12 hours, and >12 hours) in the groups was compared. The mortality and ejection fraction were investigated. In addition, the characteristics of patients and socioeconomic factors affecting STB were analyzed.
RESULTS
The SBT time is inversely associated with the ejection fraction (R=−0.126, P=0.033), and the ejection fraction of the ≤12 hours group was higher than that of the >12 hours group (54% vs. 50%, P=0.047). On the other hand, there was no significant difference in mortality between the two groups (3.26% vs. 4.84%, P=0.506). In multivariate analysis, the variable related to SBT was only typical chest pain (adjusted odd ratio, 1.931; 95% confidential interval, 1.014-3.792; P=0.045).
CONCLUSION
The results of the study support the prognostic value of SBT in STEMI undergoing PPCI. Therefore, efforts should be made to shorten the STB time.

Keyword

Symptom to balloon time; Segment elevation myocardial infarction; Percutaneous coronary intervention

MeSH Terms

Chest Pain
Hand
Humans
Mortality
Multivariate Analysis
Myocardial Infarction*
Percutaneous Coronary Intervention*
Reperfusion
Socioeconomic Factors