A Retrospective Analysis of Door-to-Balloon Time and Its Determinants in STEMI Patients

Abstract

Aims: Door-to-ballon time directly impacts the prognosis of STEMI patients, reducing door-to-balloon time (Time taken from the patient's arrival at the hospital to catheter guidewire crosses the culprit lesion in the cath lab) and early reperfusion is essential in STEMI treatment. Hence, our study aims to determine the factors that prolong door-to-balloon time. Study Design: This is a retrospective study. Place and Duration of Study: Department of Cardiology, Aster Ramesh Hospitals, Vijayawada, India. It was done retrospectively on patients who visited the hospital between January and May 2024.  Methodology: The study included patients arriving at the emergency department diagnosed with STEMI and underwent angioplasty. the study employed a pre-designed data collection form covering demographic data, past medical history, the time when the patient entered the emergency department (ed), the first ECG time, door-to-balloon time, and why the door-to-balloon time was delayed. Results: a total of 170 patient’s data was collected, of these, 75% were male and 25% were female. The mean door-to-balloon time (D-to-B) was 2 hours, 29 minutes. subjects were divided into group I (DTBT ≤90 min, n=90), group II (DTBT 91-120 min, n=40), group III (DTBT 121-180 min, n=22), and group IV (DTBT >180 min, n=18). among the patients whose DTB > 90 min, 31% of the delays were due to difficulty in assimilating and understanding the severity of the disease, 30% wanted to take a second opinion, 29% were delayed due to financial issues, and 10% were having problems with hemodynamic abnormalities that prevent rapid management in the cath lab (e.g., an active source of sepsis). Conclusion: for patients, a DTB time of 90 minutes can be attained with efficient hospital strategies. difficulty in assimilating and understanding the severity of the disease is the primary cause of the DTB time delay in this study. Socioeconomic and cultural barriers adversely affect the door to balloon time in diverse countries like India. public awareness campaigns nationwide about common medical emergencies and their solutions may favourably improve treatment in the golden hour.