Feature | March 06, 2013

The National Average for D2B Times

A recent review of data from the CathPCI Registry

A recent review of data from the CathPCI Registry, part of the American College of Cardiology’s (ACC) National Cardiovascular Data Registry (NCDR), offers some insight into average, real-world D2B times.[1] For STEMI patients who arrived at an angioplasty-capable hospital, the average time from hospital arrival to treatment was 64.5 minutes. For patients requiring transfer to another hospital, the average time from arrival at the first hospital to treatment was 121 minutes.  


The ACC 2013 STEMI guidelines estimated that almost 90 percent of patients presenting to a hospital with PCI capability and without a clinical reason for delay have a D2B time ?90 minutes.[2] Some centers have implemented protocols and technology to reduce this to much faster times. In addition, with improvements in timeliness of care across the country, racial disparities in reperfusion times have been reduced significantly, the guidleines state.


The guidelines found that for STEMI patients reported by hospitals to the Centers for Medicare and Medicaid Services, median D2B times fell from 96 minutes in the year ending Dec. 31, 2005, to 64 minutes in the three quarters ending Sept. 30, 2010. This decline was accompanied by an increase in the percentage of patients with D2B times <90 minutes, from 44.2 to 91.4 percent. However, despite substantial improvements in D2B times, evidence that these efforts have translated into reduced mortality rates is lacking, the authors found. The absence of demonstrated benefit may relate to reduced power to show change in survival in a population with a relatively low mortality rate, improved early survival of higher-risk patients and changing STEMI demographics.  The guideline authors said these findings support the goal of comprehensive efforts to improve all aspects of acute myocardial infaction care to improve survival rates.


To read more on how to lower door-to-balloon times, read the story linked here.


 


References:


1. Gregory Dehmer, Douglas Weaver, Matthew T. Roe, et al. “A Contemporary View of Diagnostic Cardiac Catheterization and Percutaneous Coronary Intervention in the United States: A Report From the CathPCI Registry of the National Cardiovascular Data Registry, 2010 Through June 2011.” J Am Coll Cardiol. 2012;60(20): 2017-2031.


2. Patrick O’Gara, Fredrick Kushner, Deborah Ascheim, et al. “2013 ACCF/AHA Guideline for Management of ST-Elevation Myocardial Infarction.” JACC Vol. 61, No. 4, Jan. 2013.


Related Content

European interventional cardiology market, drug-eluting stents, Abbott Laboratories, Boston Scientific, Medtronic

Boston Scientific's Eluvia drug-eluting vascular stent system. Image courtesy of Boston Scientific.

Feature | Stents| July 31, 2015
According to a new report on the Europe market for interventional cardiology by iData Research, drug-eluting stents...
Navidea, Mass General, Tc99m-tilmanocept, vulnerable plaque, cardiovascular disease, Harvard
News | Radiopharmaceuticals and Tracers| July 30, 2015
Navidea Biopharmaceuticals Inc. announced plans to move forward with a joint study of the ability of Tc99m-tilmanocept...
Hansen Medical, Magellan 10 French Robotic Catheter, FDA 510(k) clearance
Technology | Robotic Systems| July 29, 2015
The Magellan 10 French Robotic Catheter from Hansen Medical is indicated for use in the peripheral vasculature.
MSCs, stem cells, end-stageheart failure, retrograde, coronary sinus,
News | Stem Cell Therapies| July 29, 2015
A new clinical trial to test how a high dose of stem cells delivered via a method called retrograde coronary sinus...
Products | Guidewires| July 28, 2015
The Safari2 Pre-Shaped Guidewire.
CSI, ViperWire Advance Peripheral Guide Wire with Flex Tip, Stealth, Diamondback

Diamondback 360 Peripheral OAS image courtesy of Cardiovascular Systems Inc.

Technology | Atherectomy Devices| July 22, 2015
Cardiovascular Systems Inc. announced that it has received U.S. Food and Drug Administration (FDA) clearance for its...
heart failure, Adaptive CRT trial, AdaptivCRT algorithm, readmissions
News | Heart Failure| July 22, 2015
Heart failure patients had a significantly lower chance of being readmitted within 30 days of discharge when treated...
Direct Flow Medical, Transcatheter Aortic Valve System, SALUS Trial, FDA
News | Heart Valve Repair| July 22, 2015
Direct Flow Medical Inc. received Investigational Device Exemption (IDE) approval from the U.S. Food and Drug...
The Medicines Company, bivalirudin, Angiomax, litigation, Hospira Inc.
News | Cath Lab| July 22, 2015
The Medicines Company announced the U.S. Court of Appeals for the Federal Circuit Court has ruled against the company...
Xarelto, anticoagulant protocol, discharge, outcomes, DVT, PE
News | Antiplatelet and Anticoagulation Therapies| July 21, 2015
Two companion papers published in Academic Emergency Medicine  address the question of when it is appropriate to...
Overlay Init