TY - JOUR
T1 - Shorter door-to-balloon time, better long-term clinical outcomes in ST-segment elevation myocardial infarction patients
T2 - J-MINUET substudy
AU - J-MINUET investigators
AU - Nishio, Ryota
AU - Ogita, Manabu
AU - Suwa, Satoru
AU - Nakao, Koichi
AU - Ozaki, Yukio
AU - Kimura, Kazuo
AU - Ako, Junya
AU - Noguchi, Teruo
AU - Fujimoto, Kazuteru
AU - Dai, Kazuoki
AU - Morita, Takashi
AU - Shimizu, Wataru
AU - Saito, Yoshihiko
AU - Hirohata, Atsushi
AU - Morita, Yasuhiro
AU - Inoue, Teruo
AU - Okamura, Atsunori
AU - Mano, Toshiaki
AU - Wake, Minoru
AU - Tanabe, Kengo
AU - Shibata, Yoshisato
AU - Tsutsui, Hiroshi
AU - Funayama, Hiroshi
AU - Kokubu, Nobuaki
AU - Kozuma, Ken
AU - Uemura, Shirou
AU - Toubaru, Tetsuya
AU - Saku, Keijiro
AU - Oshima, Shigeru
AU - Yoshikawa, Yusuke
AU - Ogata, Soshiro
AU - Nishimura, Kunihiro
AU - Miyamoto, Yoshihiro
AU - Ishihara, Masaharu
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/6
Y1 - 2023/6
N2 - Background: The impact of shorter door-to-balloon (DTB time on long-term outcomes in ST-segment elevation myocardial infarction (STEMI treated with primary percutaneous coronary intervention (PPCI has not been fully elucidated. Methods: We investigated 3283 consecutive patients with acute myocardial infarction selected from a prospective, nationwide, multicenter registry (J-MINUET database comprising 28 institutions in Japan between July 2012 and March 2014. Among the study population, we analyzed 1639 STEMI patients who had PPCI within 12 h of onset. Patients were stratified into four groups (DTB time < 45 min, 45–60 min, 61–90 min, >90 min. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure, and urgent revascularization for unstable angina up to 3 years. We performed landmark analysis for incidence of the primary endpoint from 31 days to 3 years among the four groups. Results: The primary endpoint rate from 31 days to 3 years increased significantly and time-dependently with DTB time (10.2 % vs. 15.3 % vs. 16.2 % vs. 19.3 %, respectively; log-rank p = 0.0129. Higher logarithm-transformed DTB time was associated with greater risk of a primary endpoint from 31 days to 3 years, and the increased number of adverse long-term clinical outcomes persisted even after adjusting for other independent variables. Conclusion: Shorter DTB time was associated with better long-term clinical outcomes in STEMI patients treated with PPCI in contemporary clinical practice. Further efforts to shorten DTB time are recommended to improve long-term clinical outcomes in STEMI patients. Trial registration: UMIN Unique trial Number: UMIN000010037.
AB - Background: The impact of shorter door-to-balloon (DTB time on long-term outcomes in ST-segment elevation myocardial infarction (STEMI treated with primary percutaneous coronary intervention (PPCI has not been fully elucidated. Methods: We investigated 3283 consecutive patients with acute myocardial infarction selected from a prospective, nationwide, multicenter registry (J-MINUET database comprising 28 institutions in Japan between July 2012 and March 2014. Among the study population, we analyzed 1639 STEMI patients who had PPCI within 12 h of onset. Patients were stratified into four groups (DTB time < 45 min, 45–60 min, 61–90 min, >90 min. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure, and urgent revascularization for unstable angina up to 3 years. We performed landmark analysis for incidence of the primary endpoint from 31 days to 3 years among the four groups. Results: The primary endpoint rate from 31 days to 3 years increased significantly and time-dependently with DTB time (10.2 % vs. 15.3 % vs. 16.2 % vs. 19.3 %, respectively; log-rank p = 0.0129. Higher logarithm-transformed DTB time was associated with greater risk of a primary endpoint from 31 days to 3 years, and the increased number of adverse long-term clinical outcomes persisted even after adjusting for other independent variables. Conclusion: Shorter DTB time was associated with better long-term clinical outcomes in STEMI patients treated with PPCI in contemporary clinical practice. Further efforts to shorten DTB time are recommended to improve long-term clinical outcomes in STEMI patients. Trial registration: UMIN Unique trial Number: UMIN000010037.
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U2 - 10.1016/j.jjcc.2023.01.008
DO - 10.1016/j.jjcc.2023.01.008
M3 - Article
C2 - 36736534
AN - SCOPUS:85149687781
SN - 0914-5087
VL - 81
SP - 564
EP - 570
JO - Journal of cardiology
JF - Journal of cardiology
IS - 6
ER -