{"id":"0a42f1faa0b9","type":"article","url":"https://hartvaat.nl/2018/08/01/door-to-balloon-tijd-en-uitkomsten-bij-stemi-meta-analyse/","title":"Door-to-balloon tijd en uitkomsten bij STEMI: meta-analyse","title_en":"Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: a meta-analysis.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2017-312517","source_url":"https://doi.org/10.1136/heartjnl-2017-312517","authors":["Chee Yoong Foo","Kwadwo Osei Bonsu","Brahmajee K Nallamothu","Christopher M Reid","Teerapon Dhippayom","Daniel D Reidpath","Nathorn Chaiyakunapruk"],"significance":7,"published":"2018-08-01","source_date":"2018-08-01","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/"],"congress":"","summary_en":"This meta-analysis quantified the relationship between door-to-balloon time and outcomes in STEMI, confirming that shorter reperfusion times are associated with better survival and reinforcing the importance of rapid primary PCI systems.","created":"2026-07-03T10:27:23Z","updated":"2026-07-03T13:26:38Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse naar het verband tussen door-to-balloon tijd en uitkomsten bij STEMI. Onderbouwt het belang van snelle reperfusie.","abstract_original":"OBJECTIVE: This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers. METHODS: We conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure. RESULTS: 32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time-risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran's Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays. CONCLUSION: Longer door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time-risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA. CLINICAL TRIAL REGISTRATION: PROSPERO (CRD42015026069)."}