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

HeartFlow, FFR-CT, ruptured coronary plaques, EMERALD study, EuroPCR 2016
News | CT Angiography (CTA)| May 23, 2016
First-in-human data presented at EuroPCR 2016 demonstrate that hemodynamic data from HeartFlow Inc. may help predict...
TAVR outcomes, aortic valve gradient, JACC study
News | Heart Valve Technology| May 23, 2016
Patients with a combination of left ventricular dysfunction and low aortic valve gradient have higher mortality rates...
Direct Flow Medical, TAVR device, DISCOVER trial, three-year results, EuroPCR 2016
News | Heart Valve Technology| May 20, 2016
Direct Flow Medical Inc. presented three-year results from its prospective, multicenter DISCOVER Trial at the EuroPCR...
PCI, OFDI, OCT, optical coherence tomography, optimal frequency domain imaging, EuroPCR 2016 study
News | Intravascular Imaging| May 20, 2016
Using optimal frequency domain imaging (OFDI) to guide percutaneous coronary intervention (PCI) with second-generation...
Watchman, left atrial appendage closure, LAA occluder, LAA. LAAO, laa occluder, left atrial appendage, Watchman

The Boston Scientific Watchman device is currently the only transcatheter LAA occluder cleared for use in the United States.

Feature | Left Atrial Appendage (LAA) Occluders| May 20, 2016 | Dave Fornell
Atrial fibrillation (AF) affects nearly 6 million Americans and the condition puts them at significantly greater risk
Bioventrix, Revivent-TC System, heart failure, first-in-man procedure
News | Heart Failure| May 19, 2016
BioVentrix announced the first-in-man use of its next-generation Revivent-TC System with an endovascular catheter-based...
St. Jude Medical, EuroPCR 2016 studies, FFR, LAAO, left atrial appendage occlusion, fractional flow reserve, Amplatzer
News | Cath Lab| May 19, 2016
St. Jude Medical Inc. announced results from two cardiovascular clinical trials presented at EuroPCR 2016.
clot, coronary thrombus, antiplatelet therapt, DAPT

An intravascular ultrasound (IVUS) image of a thrombus formed in a coronary artery.  While there are guidelines for antiplatelet therapy, there are still questions over the duration of such therapy. 

Feature | Antiplatelet and Anticoagulation Therapies| May 19, 2016 | Marianne Pop, Pharm.D., BCPS
There are many opinions on the duration of dual antiplatelet therapy (DAPT), highlighted at the 2016 American College
bioabsorbable vascular graft, children, feasibility study, Bakoulev Center Moscow, AATS 2016 meeting

Image courtesy of Bakoulev Scientific Center for Cardiovascular Surgery

News | Stent Grafts| May 18, 2016
Bioabsorbable heart valves or blood vessels are designed to harness the body’s innate healing process, enabling the...
RDAVR, aortic valve replacement, Edwards Intuity, TRANSFORM Trial, AATS meeting
News | Heart Valve Technology| May 18, 2016
The TRANSFORM trial was designed to evaluate the safety and performance of an investigational rapid deployment aortic...
Overlay Init