• Vol. 37 No. 7, 568–572
  • 15 July 2008

Improving Door-to-balloon Times in Primary Percutaneous Coronary Intervention for Acute ST-elevation Myocardial Infarction: The Value of an Audit-driven Quality Initiative



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Introduction: The study was designed to reduce door-to-balloon times in primary percutaneous coronary intervention for patients presenting to the Emergency Department with acute ST-elevation myocardial infarction, using an audit as a quality initiative.

Materials and Methods: A multidisciplinary workgroup performed a pilot study over 3 months, then implemented various process and work-flow strategies to improve overall door-to-balloon times.

Results and Conclusion: We developed a guideline-based, institution-specific written protocol for triaging and managing patients who present to the Emergency Department with symptoms suggestive of STEMI, resulting in shortened median door-to-balloon times from 130.5 to 109.5 minutes (P<0.001).

Primary percutaneous coronary intervention (PCI) for patients with acute ST-elevation myocardial infarction (STEMI) has been shown to be superior to thrombolytic therapy in terms of its ability to achieve higher patency rates, minimise infarct size, improve left ventricular function and improve long-term survival, as well as lower rates of reinfarction and stroke. Infarct-related vessel patency is achieved more frequently and consistently with PCI, even when compared with outcomes where second and third generation thrombolytics are employed.

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