Impact of Door-to-Balloon Time on Outcomes in STEMI Patients Undergoing Primary PCI

Abstract

Objectives: This study aims to evaluate the impact of Door-to-Balloon (D2B) time on clinical outcomes in patients with ST-Segment Elevation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PCI) at the Department of Cardiology, Hayatabad Medical Complex, Peshawar. Methodology: A total of 200 STEMI patients were included in this prospective observational study conducted from August 2023 to July 2024. Patients were divided into two groups: ≤60 minutes D2B time (n=100) and >60 minutes D2B time (n=100). Clinical outcomes such as in-hospital mortality, Major Adverse Cardiac Events (MACE), and overall survival rates were assessed. Statistical analysis included chi-square tests, t-tests, and regression models, with statistical significance defined as p<0.05. Results: Among the cohort, 65% of patients had D2B times ≤60 minutes, while 35% had D2B times >60 minutes. The ≤60-minute group demonstrated significantly lower in-hospital mortality (2%) compared to the >60-minute group (12%) (p=0.0001). MACE incidence was also lower in the ≤60-minute group (4%) compared to the >60-minute group (20%) (p=0.0002). The overall survival rate was 98% in the ≤60-minute group versus 85% in the >60-minute group (p=0.0003). Conclusion: Shorter D2B times significantly reduce in-hospital mortality, MACE, and improve overall survival in STEMI patients undergoing PCI. These findings underscore the importance of reducing delays and optimizing reperfusion strategies, particularly in low-resource healthcare settings, to enhance patient outcomes.