# Door-to-balloon tijd en uitkomsten bij STEMI: meta-analyse

*geplaatst 2018-08-01 · Algemeen · Heart (British Cardiac Society) · doi 10.1136/heartjnl-2017-312517 · https://hartvaat.nl/2018/08/01/door-to-balloon-tijd-en-uitkomsten-bij-stemi-meta-analyse/*

Meta-analyse naar het verband tussen door-to-balloon tijd en uitkomsten bij STEMI. Onderbouwt het belang van snelle reperfusie.

## English: Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: a meta-analysis.

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.

## Abstract (original, from the publication)

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).

Auteurs: Chee Yoong Foo, Kwadwo Osei Bonsu, Brahmajee K Nallamothu, Christopher M Reid, Teerapon Dhippayom, Daniel D Reidpath, Nathorn Chaiyakunapruk

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Bron: Heart (British Cardiac Society), https://doi.org/10.1136/heartjnl-2017-312517. Bijgewerkt 2026-07-03T13:26:38Z. 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.