Door-to-balloon (DTB) time is an important quality measure for ST-segment myocardial elevation infarction (STEMI). Aggressive measures to reduce DTB time can increase the incidence of false positive-STEMI and may increase mortality in that group. Efforts to reduce DTB time should be monitored systematically to avoid unnecessary procedures especially in critically ill patients who don't have STEMI and may benefit from other appropriate therapies in timely manner. We report two cases where trying to achieve an aggressive DTB time may have led to unwarranted outcomes.
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Cureus
November 2024
Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, USA.
Background Rapid treatment of ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) significantly reduces morbidity and mortality rates. Recent studies emphasize the importance of reducing total ischemic time, making first-medical-contact-to-balloon (FMCTB) time a key performance indicator. To improve FMCTB times in patients brought to the Emergency Department (ED) by Emergency Medical Services (EMS), we implemented a "Direct to Lab" (DTL) workflow during the following conditions: weekday daytime hours, when the lab is fully staffed, and for hemodynamically stable STEMI patients presenting via EMS.
View Article and Find Full Text PDFPanminerva Med
December 2024
Division of Cardiology, Santa Maria Goretti Hospital, Latina, Italy.
Background: Prompt reperfusion is critical for patients with ST-segment elevation myocardial infarction (STEMI) to improve outcomes. Yet, variability in regional healthcare delivery may influence treatment times and patient outcomes. We thus aimed at evaluating differences in management and outcomes of STEMI patients across Northern, Central, and Southern Italy, focusing on time-dependent reperfusion and in-hospital logistics.
View Article and Find Full Text PDFPlant Cell Environ
October 2024
Department of Forest Mycology and Plant Pathology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Diplodia sapinea causes Diplodia tip blight (DTB) and is recognised as an opportunistic necrotrophic pathogen affecting conifers. While DTB is associated with abiotic stress, the impact of biotic stress in the host on D. sapinea's lifestyle shift is unknown.
View Article and Find Full Text PDFAm J Transl Res
July 2024
Department of Cardiology, Union Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan 430000, Hubei, China.
Objective: To evaluate the impact of combining action research theory with focus-solving short-term psychotherapy on the psychological stress, adjustment, and rehabilitation of patients with acute myocardial infarction (AMI) following percutaneous coronary intervention (PCI).
Methods: Between January 2022 and January 2023, a prospective study was conducted involving 300 AMI patients at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Participants were divided into a control group and a study group, with 150 patients in each.
Background ST-elevation myocardial infarction (STEMI) requires swift intervention, with primary percutaneous coronary intervention (PCI) being essential to limit myocardial damage. The key factor affecting PCI effectiveness is the door-to-balloon (DTB) time. This observational study evaluated DTB times in STEMI patients at a tertiary care center who underwent primary angioplasty, examining adherence to benchmarks and identifying factors contributing to delays.
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