A campaign to improve the timeliness of primary percutaneous coronary intervention - Door-to-balloon: An alliance for quality

Harlan M. Krumholz, Elizabeth H. Bradley, Brahmajee K. Nallamothu, Henry H. Ting, Wayne B. Batchelor, Eva Kline-Rogers, Amy F. Stern, Jason Byrd, John E. Brush, Peter C. Block

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

In 1971, Eugene Braunwald, MD, MACC, postulated a revolutionary hypothesis: Time is muscle. He proposed that acute myocardial infarction is a dynamic process and that the severity and extent of myocardial ischemic injury resulting from coronary occlusion could be radically altered by an appropriate intervention "as late as 3 hours after the coronary occlusion." Subsequent clinical trials confirmed that restoration of coronary patency improves survival but, to be maximally beneficial, revascularization must be induced within a time window much narrower than Dr. Braunwald proposed. For example, Brodie and colleagues evaluated 2,322 consecutive patients treated with primary PCI and followed them for a median of 83 months. Evaluating outcomes by door-to-balloon (D2B) times showed a stepwise increase in both in-hospital and long-term mortality for increasing D2B times (Slide 1). Those at highest risk benefited the most from short D2B times, especially when they presented within 3 hours of symptom onset.

Original languageEnglish (US)
Pages (from-to)49-53
Number of pages5
JournalACC Cardiosource Review Journal
Volume17
Issue number5
StatePublished - May 2008

ASJC Scopus subject areas

  • General Nursing
  • Cardiology and Cardiovascular Medicine

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