Abstract 3997: The Influence of Gender and Age on Primary Percutaneous Intervention Door to Balloon Times
Purpose: ACC/AHA practice guidelines for the management of patients with ST-elevation myocardial infarction (MI) state primary percutaneous intervention (PCI) should be performed as quickly as possible with a goal of door to balloon interval of within 90 minutes. The purpose of this study was to determine if age or gender had a significant role in the time to reperfusion.
Methods: Data were gathered prospectively from May 1999 to December 2005 on consecutive patients with acute MI presenting to a tertiary care hospital emergency department, who received initial reperfusion therapy via PCI. Patients with acute MI who did not undergo PCI as the initial reperfusion strategy and patients receiving CPR prior to arrival were excluded. The subgroups analyzed were males less than (<) 55 years old, males greater than or equal to (≥) 55 years old, females < 55 years old and females ≥ 55 years old. Mean time from arrival to the hospital (TOA) to first electrocardiogram (EKG), to decision to take patient for primary PCI, to case start, and to first PCI times were measured. Mortality data was also analyzed.
Results: TOA to first EKG times were similar among all the age groups. TOA to decision, time to case start, and time to first PCI were significantly delayed for females < 55 years old (ANOVA p < 0.0001). In-hospital mortality rates between the subgroups were not significant.
Conclusions: Females less than 55 years of age have significant delays in all time intervals, although it did not affect in-hospital mortality rates. Clinicians need to be especially attentive to this age group in order to prevent treatment delays.