Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Door-to-balloon time drops for heart attack patients, but mortality rates unchanged

09.11.2010
University of Michigan Health System leads the study showing more work to be done to prevent heart attack deaths

Door-to-balloon time has dropped dramatically as hospitals rush heart attack patients into treatment, but a five-year study released Monday shows quicker hospital care has not saved more lives.

Heart attacks are a medical emergency and hospitals race against the clock to open the clogged artery causing the attack in 90 minutes or less.

Door-to-balloon time is the amount of time between a heart attack patient's arrival at the hospital to the time he or she receives an intervention, such as a balloon angioplasty, to open the artery.

The study published in the Archives of Internal Medicine showed no change in mortality, in spite of the drops in door-to-balloon time at Michigan hospitals from 113 minutes in 2003 to 76 minutes in 2008.

The U-M Cardiovascular Center and colleagues at Michigan hospitals tracked the outcomes of 8,771 patients with acute ST-elevation myocardial infarction, commonly known as a severe heart attack.

"Considerable effort has focused on reducing door-to-balloon time with the assumption that quicker care translates into a significant reduction in mortality," says study senior author Hitinder Gurm, M.D., an interventional cardiologist at the U-M Cardiovascular Center.

"When we looked at our data, the reduction in door-to-balloon time was dramatic. However, to our surprise and dismay, we found the number of patients who died had not changed," he says.

Deaths from these heart attacks remained at about 4 percent.

Current American Heart Association and American College of Cardiology guidelines recommend getting these patients into treatment in 90 minutes or less.

"Our results suggest that a successful implementation of efforts to reduce door-to-balloon time has not resulted in the expected survival benefit," says Anneliese Flynn, M.D., a resident in the U-M Department of Internal Medicine, and lead author of the trends study.

By the end of the study period, nearly 70 percent of Michigan patients received care in the recommended DTB time. The study examined whether patients did better because of it.

"We need to do a better job at educating patients and developing sytems of care so that patients get to the hospital quicker and not only worry about the time involved once they hit the hospital door," Gurm explains.

"To improve patient outcomes we need to focus on the entire event - from the moment a person experiences chest pain to the time they get treated," he says.

Although door-to-balloon time dropped, the study showed no improvement in the time between the onset of symptoms such as chest pain, and when patients arrived at the hospital.

"It could be that the negative impact of the increased symptom-to-door time among high risk patients is sufficient to mask any potential protective effect of the decreased door-to-balloon time," Flynn says.

The Cardiovascular Consortium, called BMC2, is a collaborative network of physicians and hospitals and involves 32 Michigan hospitals that performs percutaneous coronary intervention, such as angioplasty and stents to treat patients with coronary artery diseases.

BMC2 registry is a physician lead quality improvement collaborative that is supported by the Blue Cross Blue Shield of Michigan. The collaborative works to improve outcomes of patients undergoing PCI with a special focus on reducing complications, and improving safety, efficacy and appropriateness of procedures.

The University of Michigan has been the coordinating center for BMC2 since 1997.

To learn more about signs and symptoms of a heart attack
http://www.americanheart.org/presenter.jhtml?identifier=4595
Additional authors: Mauro Moscucci, M.D., MBA, Univerity of Miami, formerly of U-M; David Share, M.D., MPH, of U-M Department of Family Medicine, Dean Smith, Ph.D, MPH, of U-M Cardiovascular Center; Thomas LaLonde, M.D., of St. John Hospital and Medical Center, Hameem Changezi, M.D., of Genesys Regional Hospital, and Arthur Riba, M.D., of Oakwood Hospital and Medical Center.

Reference: "Trends in door-to-balloon time and mortality in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention," Archives of Internal Medicine, Vol. 170, No. 20, Nov. 8, 2010

Funding: Blue Cross Blue Shield of Michigan.

Resources:
U-M Cardiovascular Center
www.umcvc.org
Blue Cross Blue Shield Cardiovascular Consortium (BMC2)
http://www.bmc2.org/

Shantell M. Kirkendoll | EurekAlert!
Further information:
http://www.umich.edu

More articles from Studies and Analyses:

nachricht Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

nachricht Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Future electronic components to be printed like newspapers

A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.

The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

A smart safe rechargeable zinc ion battery based on sol-gel transition electrolytes

20.07.2018 | Power and Electrical Engineering

Reversing cause and effect is no trouble for quantum computers

20.07.2018 | Information Technology

Princeton-UPenn research team finds physics treasure hidden in a wallpaper pattern

20.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>