Relationship of Symptom-Onset-to-Balloon Time and Door-to-Balloon Time With Mortality in Patients Undergoing Angioplasty for Acute Myocardial Infarction
JAMAPublished 14 June 2000
Christopher P. Cannon
Citations1,216
SJR quartileQ1
SJR score5.35
SNIP10.71
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The relationship in this study between increased mortality and delay in door-to-balloon time longer than 2 hours (present in nearly 50% of this cohort) suggests that physicians and health care systems should work to minimize door- to- balloon times and that door- To-Balloon time should be considered when choosing a reperfusion strategy.
Abstract
The relationship in our study between increased mortality and delay in door-to-balloon time longer than 2 hours (present in nearly 50% of this cohort) suggests that physicians and health care systems should work to minimize door-to-balloon times and that door-to-balloon time should be considered when choosing a reperfusion strategy. Door-to-balloon time also appears to be a valid quality-of-care indicator. JAMA. 2000.
Keywords
MedicineHealth Professions
Wiley series in probability and statisticsStatistical Methods for Rates and Proportions
18,048 Citations2003Joseph L. Fleiss, Bruce Levin +1 more
Statistics in MedicinePropensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group
5,302 Citations1998Ralph B. D’Agostino
This tutorial discusses the uses of propensity score methods for bias reduction, gives references to the literature and illustrates the uses through applied examples.
New England Journal of MedicineAn International Randomized Trial Comparing Four Thrombolytic Strategies for Acute Myocardial Infarction
4,059 Citations1993The GUSTO Investigators
The findings of this large-scale trial indicate that accelerated t-PA given with intravenous heparin provides a survival benefit over previous standard thrombolytic regimens.
Annals of Internal MedicineEstimating Causal Effects from Large Data Sets Using Propensity Scores
2,879 Citations1997Donald B. Rubin
Propensity score methods generalize subclassification in the presence of many confounding covariates, such as age, region of the country, and sex, in a study of smoking and mortality.
The LancetEFFECTIVENESS OF INTRAVENOUS THROMBOLYTIC TREATMENT IN ACUTE MYOCARDIAL INFARCTION
2,451 Citations1986GRUPPOITALIANOPERLOSTUDIODELL
Borås Academic Digital Archive (University of Borås)Indications for fibrinolytic therapy in suspected acute myocardial infarction : collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients
2,230 Citations1994Johan Herlitz
It is shown that fibrinolytic therapy can reduce mortality in patients with suspected acute myocardial infarction (AMI) and the indications for, and contraindications to, this therapy.
New England Journal of MedicineA Comparison of Immediate Angioplasty with Thrombolytic Therapy for Acute Myocardial Infarction
1,997 Citations1993Cindy L. Grines, Kevin F. Browne +12 more
The use of immediate percutaneous transluminal coronary angioplasty (PTCA), without previous thrombolytic therapy, for acute myocardial infarction is hypothesized to overcome bleeding complications, the impossibility of reperfusing all occluded coronary arteries, and the relatively small number of patients who are appropriate candidates for this therapy.
CirculationThe wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs.
1,926 Citations1977K A Reimer, J. E. Lowe +2 more
The results document the presence of a subepicardial zone of ischemic but viable myocardium which is available for pharmacologic or surgical salvage for at least three and perhaps six hours following circumflex occlusion in the dog.
New England Journal of MedicineThe Effects of Tissue Plasminogen Activator, Streptokinase, or Both on Coronary-Artery Patency, Ventricular Function, and Survival after Acute Myocardial Infarction
1,865 Citations1993The GUSTO Angiographic Investigators
Journal of the American College of CardiologyACC/AHA guidelines for the management of patients with acute myocardial infarction
1,853 Citations1996Thomas J. Ryan, Jeffrey L. Anderson +20 more
These practice guidelines are intended to assist physicians and other healthcare providers in clinical decision making by describing a range of generally acceptable approaches for the diagnosis, management, or prevention of specific diseases or conditions.
New England Journal of MedicineA Comparison of Immediate Coronary Angioplasty with Intravenous Streptokinase in Acute Myocardial Infarction
1,295 Citations1993Felix Zijlstra, Menko Jan de Boer +4 more
Immediate angioplasty after acute myocardial infarction was associated with a higher rate of patency of the infarct-related artery, a less severe residual stenotic lesion, better left ventricular function, and less recurrentMyocardial ischemia andinfarction than was intravenous streptokinase.
American Journal of EpidemiologyInvited Commentary: Propensity Scores
1,056 Citations1999Marshall M. Joffe, Peter Rosenbaum
The authors present a new result of using propensity scores in case-cohort studies and review the uses and limitations of propensity scores and provide a brief outline of associated statistical theory.
JAMAComparison of Primary Coronary Angioplasty and Intravenous Thrombolytic Therapy for Acute Myocardial Infarction
1,006 Citations1997Will Weaver
Based on outcomes at hospital discharge or 30 days, primary angioplasty appears to be superior to thrombolytic therapy for treatment of patients with acute myocardial infarction, with the proviso that success rates for angiopLasty are as good as those achieved in these trials.
New England Journal of MedicineA Clinical Trial Comparing Primary Coronary Angioplasty with Tissue Plasminogen Activator for Acute Myocardial Infarction
944 Citations1997Maarten L. Simoons
This trial suggests that angioplasty provides a small-to-moderate, short-term clinical advantage over thrombolytic therapy with t-PA, and should be considered an excellent alternative method for myocardial reperfusion.
CirculationAbciximab Facilitates the Rate and Extent of Thrombolysis
687 Citations1999Elliott M. Antman, Robert P. Giugliano +14 more
Abciximab facilitates the rate and extent of thrombolysis, producing early, marked increases in TIMI 3 flow when combined with half the usual dose of alteplase, and substantial reductions in heparin dosing may reduce the risk of bleeding even further.
Journal of the American College of CardiologyTime from symptom onset to treatment and outcomes after thrombolytic therapy
421 Citations1996L. Kristin Newby, Wolfgang Rutsch +8 more
Earlier treatment resulted in better outcomes, regardless of thrombolytic strategy, in the international GUSTO-I trial.
Journal of the American College of CardiologyA randomized trial comparing primary angioplasty with a strategy of short-acting thrombolysis and immediate planned rescue angioplasty in acute myocardial infarction: the PACT trial
384 Citations1999Allan M. Ross, Karin S. Coyne +11 more
Tailored thrombolytic regimens compatible with subsequent interventions lead to more frequent early recanalization (before cath arrival), which facilitates greater LV function preservation with no augmentation of adverse events.
JAMAQuality of Care for Medicare Patients With Acute Myocardial Infarction
378 Citations1995Edward F. Ellerbeck
It is demonstrated that many Medicare patients may not be ideal candidates for standard AMI therapies, but these treatments are underused, even in the absence of discernible contraindications.
JAMACoronary Angioplasty Volume-Outcome Relationships for Hospitals and Cardiologists
342 Citations1997Edward L. Hannan
In New York State, both hospital P TCA volume and cardiologist PTCA volume are significantly inversely related to in-hospital mortality rate and same-stay CABG surgery rate for patients undergoing PTCa.
New England Journal of MedicineA Comparison of Thrombolytic Therapy with Primary Coronary Angioplasty for Acute Myocardial Infarction
337 Citations1996Nathan R. Every, Lori Parsons +3 more
This study compared mortality during hospitalization and long-term mortality, as well as the use of resources, among patients in a primary-angioplasty group and a thrombolytic-therapy group in patients with acute myocardial infarction.
Journal of the American College of CardiologyImportance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction
329 Citations1998Bruce R. Brodie, Thomas Stuckey +6 more
Time to reperfusion, up to 2 h, is important for survival and recovery of left ventricular function and factors other than myocardial salvage may be responsible for survival benefit in patients treated with primary angioplasty after 2 h.
New England Journal of MedicineThe Relation between the Volume of Coronary Angioplasty Procedures at Hospitals Treating Medicare Beneficiaries and Short-Term Mortality
283 Citations1994James G. Jollis, Eric D. Peterson +5 more
If the hospitals with the lowest volume had achieved the experience and technical results of the highest-volume hospitals, 381 fewer patients would have undergone CABG and there would have been 300 fewer in-hospital deaths in the population the authors studied.
Journal of the American College of CardiologySafety and Cost-Effectiveness of Early Discharge After Primary Angioplasty in Low Risk Patients With Acute Myocardial Infarction 11Research funding for this study was provided by unrestricted grants from Advanced Cardiovascular Systems, Santa Clara, California; Mallinckrodt Medical, Inc., Saint Louis, Missouri; Datascope Corporation, Montvale, New Jersey; St. Jude Medical, Chelmsford, Massachusetts; and Siemens Corporation, Iselin, New Jersey.
276 Citations1998Cindy L. Grines, Dominic L. Marsalese +17 more
Early identification of low risk patients with myocardial infarction allowed safe omission of the intensive care phase and noninvasive testing, and a day 3 hospital discharge strategy, resulting in substantial cost savings.
CirculationRelationship Between Physician and Hospital Coronary Angioplasty Volume and Outcome in Elderly Patients
216 Citations1997James G. Jollis, Eric D. Peterson +5 more
It is suggested that adherence to minimum volume standards by physicians and hospitals will lead to better outcomes for elderly patients undergoing coronary angioplasty.
Journal of the American College of CardiologyClinical Experience With Primary Percutaneous Transluminal Coronary Angioplasty Compared With Alteplase (Recombinant Tissue-Type Plasminogen Activator) in Patients With Acute Myocardial Infarction
214 Citations1998Alan J. Tiefenbrunn, Nisha C. Chandra +3 more
It is suggested that in lytic-eligible patients not in shock, PTCA and rt-PA are comparable alternative methods of reperfusion when analyzed in terms of in-hospital mortality, mortality plus nonfatal stroke and reinfarction.
JAMAThe Relationship Between Coronary Angioplasty Procedure Volume and Major Complications
183 Citations1995Stephen E. Kimmel
An inverse association between cardiac catheterization laboratory procedure volume and major complications during PTCA exists independent of differences in patients' risk profiles, and the currently recommended minimum laboratory volume may be too low to distinguish higher-risk from lower-risk laboratories.
Journal of the American College of CardiologyComparison of front-loaded recombinant tissue-type plasminogen activator, anistreplase and combination thrombolytic therapy for acute myocardial infarction: Results of the thrombolysis in myocardial infarction (TIMI) 4 trial
180 Citations1994Christopher P. Cannon, Carolyn H. McCabe +13 more
Front-loaded rt-PA achieved significantly higher rates of early reperfusion of the infarct-related artery and was associated with trends toward better overall clinical benefit and survival than those achieved with a standard thrombolytic agent or combination thrombotic therapy.
New England Journal of MedicineThe Open-Artery Theory Is Alive and Well -- Again
154 Citations1993Eugene Braunwald
The foundation of modern therapy for acute myocardial infarction was laid in 1941 by Blumgart et al., who demonstrated that in dogs with transient coronary occlusion, the extent of myocardIAL infarctions was limited by the presence of plaque.
Journal of the American College of CardiologyAbciximab in the treatment of acute myocardial infarction eligible for primary percutaneous transluminal coronary angioplasty
138 Citations1999Lambert F.M van den Merkhof, Felix Zijlstra +7 more
Abciximab therapy given in the emergency room in patients awaiting primary angioplasty is associated with full reperfusion (TIMI flow grade 3) in about 20% and with TIMI flow level 2 or 3 in about 40% of the patients at a median time of 45 min.
Journal of the American College of CardiologyA comparison of the National Registry of Myocardial Infarction 2 with the Cooperative Cardiovascular Project
120 Citations1999Nathan R. Every, Paul D Frederick +4 more
It is concluded that the simpler case ascertainment and data collection strategies employed by NRMI 2 result in process and outcome measures that are comparable to the more rigorous methods utilized by the CCP.
CirculationTreatment of Acute Myocardial Infarction by Primary Coronary Angioplasty or Intravenous Thrombolysis in the “Real World”
118 Citations1999Nicolas Danchin, L Vaur +5 more
The results of this large registry of real-world practice indicate no survival benefit for patients treated with primary angioplasty compared with those who received thrombolytic therapy.
The American Journal of CardiologyImpact of time to treatment with tissue plasminogen activator on morbidity and mortality following acute myocardial infarction (the second National Registry of Myocardial Infarction)
105 Citations1998Robert J. Goldberg, Michael Mooradd +5 more
It is suggested that patients with AMI treated earlier with t-PA are significantly more likely to survive the acute hospitalization than patients treated later and for community-wide efforts to reduce the duration of prehospital delay in patients with acute coronary disease.
Journal of Thrombosis and ThrombolysisTime as an adjunctive agent to thrombolytic therapy
104 Citations1994Christopher P. Cannon, Elliott M. Antman +2 more
Efforts to reduce each of the time delay between the onset of MI and achievement of reperfusion will lead to additive benefits in improving time to reperfusions and survival of patients with acute MI.
The American Journal of CardiologyEffect of Continuous Quality Improvement Analysis on the Delivery of Primary Percutaneous Transluminal Coronary Angioplasty for Acute Myocardial Infarction
93 Citations1997Ronald Caputo, Kalon K.L. Ho +8 more
A learning effect following initiation of a primary PTCA program is demonstrated in which reperfusion was more rapidly achieved as the result of procedural changes directed by quality improvement analysis with a concurrent improvement in in-hospital outcomes.
Journal of the American College of CardiologyOperator volume and outcome of patients undergoing coronary stent placement
83 Citations1998Adnan Kastrati, Franz–Josef Neumann +1 more
It is demonstrated that an experience of at least 100 procedures is required to obtain better outcome even in patients with simple coronary lesions and that operators should perform at least 70 procedures annually to expect a better outcome in Patients with both simple and complex coronary lesions.
The American Journal of CardiologyComparison of primary angioplasty versus thrombolytic therapy for acute myocardial infarction
64 Citations1994William Rogers, The Alabama Registry of Myocardial Ischemia Investigators +5 more
Survival at 1-year follow-up was 88% in the PTCA group and 91% inThe thrombolytic group, and survival free of reinfarction was 85% and 88%, respectively (p = NS).
The American Journal of CardiologyPrimary Angioplasty Versus Thrombolysis in the Treatment of Acute Myocardial Infarction
44 Citations1997Ralf Zahn, Armin Koch +7 more
A superiority of primary angioplasty in comparison to intravenous thrombolysis in AMI even in a clinical routine setting is indicated, with a reduction of hospital mortality of about 60%.
Journal of Thrombosis and ThrombolysisTime to reperfusion: The critical modulator in thrombolysis and primary angioplasty
41 Citations1996ChristopherP. Cannon, Eugene Braunwald
Time to reperfusion appears to be the critical modulator in both thrombolysis and primary angioplasty, and a clear relationship exists between higher rates of early reperfusions and lower mortality.
The American Journal of CardiologyDangers of Delay of Initiation of Either Thrombolysis or Primary Angioplasty in Acute Myocardial Infarction With Increasing Use of Primary Angioplasty
35 Citations1998Andrew J. Doorey, Sachin Patel +7 more
Delayed time intervals to balloon reperfusion probably contributed to these adverse outcomes, with hemodynamic instability requiring pressors or intra-aortic balloon pumping in 15 patients, 12 (75%) before the first balloon inflation.
The American Journal of CardiologyEditorial
16 Citations1996Judith L. Anderson, Labros A. Karagounis +1 more
A predictive model based on differences in 5 treatment-related factors, including time to therapy, patency success, and angioplasty experience, suggests that relative outcomes may indeed vary, depending on the clinical setting in which therapy is given.
American Heart JournalTimely thrombolysis: Synergism to open arteries and reduce mortality rates
13 Citations1999Christopher P. Cannon
Journal of the American College of Cardiology755-2 Current Management of ST Elevation Myocardial Infarction and Outcome of Thrombolytic Ineligible Patients: Results of the Multicenter TIMI 9 Registry
12 Citations1995Christopher P. Cannon, Timothy D. Henry +8 more
Early mortality was similar for Tlysis and l° PTCA, but highest for medically treated pts, which supports further expansion of reperfusion therapy in ST elevation MI and the need for improved medical therapies for thrombolytic ineligible patients.