Effects of Door-In to Door-Out Time on Mortality Among ST-Segment Elevation Myocardial Infarction Patients Transferred for Primary Percutaneous Coronary Intervention ― Systematic Review and Meta-Analysis ―

Abstract

STEMI (n=10,242) who undergoing primary PCI was 4%. 2 A previous guideline recommended a door-to-balloon time of <90 min when STEMI patients are admitted to PCI-capable hospitals. 3 However, the CREDO-Kyoto Acute Myocardial Infarction (AMI) Registry, a large-scale observational study of AMI in Japan, revealed that long-term clinical outcomes were not significantly different between P rimary percutaneous coronary intervention (PCI) for patients with ST-elevation myocardial infarc-tion (STEMI) is now widely accepted as an acute treatment. The efficacy of timely PCI has also been established. 1 A recent analysis of 20,042 acute coronary syndrome (ACS) patients from a Japanese nationwide registry revealed that the overall 30-day all-cause mortality rate of Background: Primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is now widely accepted. Recent guidelines have focused on total ischemic time, because shorter total ischemic time is associated with a more favorable prognosis. The door-in to door-out (DIDO) time, defined as time from arrival at a non-PCI-capable hospital to leaving for a PCI-capable hospital, may affect STEMI patient prognosis. However, a relevant meta-analysis is lacking.