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Revista argentina de cardiología
On-line version ISSN 1850-3748
Abstract
FURMENTO, Juan et al. Optimization of Door-to-Balloon Time Implementing a Process Improvement Program. Results after 5 Years. Rev. argent. cardiol. [online]. 2023, vol.91, n.2, pp.144-148. ISSN 1850-3748. http://dx.doi.org/10.7775/rac.es.v91.i2.20614.
Background
: If available, primary transluminal coronary angioplasty (PTCA), performed timely and in experienced sites, is the best reperfusion strategy for ST elevation myocardial infarction (STEMI). The door-to-balloon (DTB) time expresses operational efficiency of the site in charge of the PTCA, with an impact on patient’s progress. The aim of this study was to analyze the long-term results of a continuous improvement program for the DTB time process.
Methods
: Patients diagnosed with STEMI who had undergone PTCA from January 2015 to May 2022 were prospectively and consecutively enrolled. The population was divided in two periods: an immediate implementation period and a long-term follow-up period.
Results
: 671 patients were prospectively and consecutively enrolled. During the implementation period (P1) 91 patients were enrolled, and 580 during the program follow-up (P2). The median (interquartile range, IQR) DTB time was 46 min (29-59) for P1 vs 42 min(25-52) for P2, p=0.055). The second period showed a reduction in pre-activations (P1 54,1% vs P2 30% p=0.02) and on-hour procedures (42% for P1 versus 30% for P2, p=0.029).
Conclusion
: The registry showed long-term maintenance of good results, despite reduced reactivations and on-hour procedures.
Keywords : Myocardial Infarction; Angioplasty; Time-to-Treatment.