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Effects of Door-In to Door-Out Time on Mortality Among ST-Segment Elevation Myocardial Infarction Patients Transferred for Primary Percutaneous Coronary Intervention ― Systematic Review and Meta-Analysis ―
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- Yamaguchi Junichi
- Department of Cardiology, Tokyo Women’s Medical University
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- Matoba Tetsuya
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
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- Kikuchi Migaku
- Department of Cardiovascular Medicine, Emergency and Critical Care Center, Dokkyo Medical University
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- Minami Yuichiro
- Department of Cardiology, Tokyo Women’s Medical University
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- Kojima Sunao
- Department of Internal Medicine, Sakurajyuji Yatsushiro Rehabilitation Hospital
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- Hanada Hiroyuki
- Department of Emergency and Disaster Medicine, Hirosaki University
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- Mano Toshiaki
- Department of Cardiology, Kansak Rosai Hospital
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- Nakashima Takahiro
- Department of Emergency Medicine and Michigan Center for Integrative Research in Critical Care, University of Michigan
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- Hashiba Katsutaka
- Department of Cardiology, Saiseikai Yokohama-shi Nanbu Hospital
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- Yamamoto Takeshi
- Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
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- Tanaka Akihito
- Department of Cardiology, Nagoya University Graduate School of Medicine
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- Matsuo Kunihiro
- Department of Acute Care Medicine, Fukuoka University Chikushi Hospital
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- Nakayama Naoki
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center
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- Nomura Osamu
- Department of Emergency and Disaster Medicine, Hirosaki University
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- Tahara Yoshio
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Nonogi Hiroshi
- Faculty of Health Science, Osaka Aoyama University
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Description
<p>Background:Primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is now widely accepted. Recent guidelines have focused on total ischemic time, because shorter total ischemic time is associated with a more favorable prognosis. The door-in to door-out (DIDO) time, defined as time from arrival at a non-PCI-capable hospital to leaving for a PCI-capable hospital, may affect STEMI patient prognosis. However, a relevant meta-analysis is lacking.</p><p>Methods and Results:We searched PubMed for clinical studies comparing short-term (30-day and in-hospital) mortality rates of STEMI patients undergoing primary PCI with DIDO times of ≤30 vs. >30 min. Two investigators independently screened the search results and extracted the data. Random effects estimators with weights calculated by the inverse variance method were used to determine pooled risk ratios. The search retrieved 1,260 studies; of these, 2 retrospective cohort studies (15,596 patients) were analyzed. In the DIDO time ≤30 and >30 min groups, the primary endpoint (i.e., in-hospital or 30-day mortality) occurred for 51 of 1,794 (2.8%) and 831 of 13,802 (6.0%) patients, respectively. The incidence of the primary endpoint was significantly lower in the DIDO time ≤30 min group (odds ratio 0.45; 95% confidence interval 0.34–0.60).</p><p>Conclusions:Our findings suggest that a DIDO time ≤30 min is associated with a lower short-term mortality rate. However, further larger systematic reviews and meta-analyses are needed to validate our findings.</p>
Journal
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- Circulation Reports
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Circulation Reports 4 (3), 109-115, 2022-03-10
The Japanese Circulation Society
