Navigation Links
Debate Focuses on Door-to-balloon Time in Heart Attack Treatment

In the treatment of heart attack, the 90-minute goal for inflation of an angioplasty balloon in a blocked coronary artery to restore normal blood flow is so revered its been codified in clinical guidelines, accreditation standards, and pay-for-performance programs. But is the 90-minute deadline really critical" Two experts will debate that question at the 30th Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions (SCAI).

Allowing no more than 90 minutes to elapse between patient arrival in the emergency room and inflation of the angioplasty balloonthe so-called door-to-balloon timeis clearly beneficial, said Eric R. Bates, M.D., a professor of internal medicine at the University of Michigan in Ann Arbor.

Many studies have shown that the size of a heart attack and the risk of death are directly related to the amount of time the heart is ischemic, or starved for blood and oxygen. Opening the blocked artery within 90 minutes has repeatedly been associated with better outcomes.

"For years weve known that time is muscle," Dr. Bates said. "The sooner you unblock the coronary artery, the more heart muscle you can salvage."

Timothy D. Henry, M.D., FSCAI, has no quarrel with keeping a close eye on the clock when treating heart attack patients, but said a hard-and-fast deadline may be counterproductive in some cases. "Time is important, and we need to treat patients as quickly as we can," said Dr. Henry, the director of research and an interventional cardiologist at the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis. "But there is clear evidence that 90 minutes is arbitrary."

Some studies have shown that opening the blocked artery within 120 minutes is associated with good clinical outcomes, for example. In addition, door-to-balloon time is a flawed metric, Dr. Henry said. A more clinically relevant indicator would be time to reperfusion, or re-establishment of blood flow through an open artery.

Dr. Bates countered that the 90-minute cut-off is sufficiently valid that a hospital unable to offer percutaneous coronary intervention (PCI) within that time frame should consider treating patients with clot-busting medications, rather than transporting them to a PCI-capable hospital. "Otherwise, those patients are paying a penalty for using PCI," he said.

That would be an undesirable consequence of an overly rigid goal, according to Dr. Henry. "Primary PCI is the best method of reperfusion for patients who are having a heart attack," he said. "Everyone in the United States should have the opportunity for primary PCI if they need it."


'"/>




Related medicine news :

1. Debate Rages over firing of HIV infected health care workers
2. Debate On Marriage
3. New Mexico Debates Over Forcing Mentally Ill People To Seek Treatment
4. Debate in US: Who Should Decide for Disabled People?
5. Skinny Debate Upsets Actress Knightley
6. Skinny Debate Upsets Actress Knightley
7. Republican Presidential Candidates Discuss Abortion, Stem Cells as Part of First Debate
8. Scientists Saying Against Trees Sparks Debate
9. JRRD Focuses On Issues Such As Spinal Cord Injury and Prosthetics
10. Canada Focuses Its Attention on Kids
11. Study Focuses on Womens Health After Breast Cancer
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:3/24/2017)... ... March 24, 2017 , ... “The Communion of Saints: A ... God in congregations across the United States. “The Communion of Saints” is ... who has served congregations in seven states throughout his long career of devotion ...
(Date:3/23/2017)... ... , ... A recent report from the National Council on Teacher Quality (NCTQ) ... suggests, based on a review of GPA and SAT/ACT requirements at 221 institutions in ... It argues that this higher bar should be set by states, by the Council ...
(Date:3/23/2017)... ... March 23, 2017 , ... Texas Physical Therapy Specialists (TexPTS) ... Gruene Road in Building 2. The clinic is the group’s second in New Braunfels ... opening the company’s second New Braunfels location brings things full circle for the group, ...
(Date:3/23/2017)... ... , ... The MBI “Hall of Fame” recognizes the contributions of those whose careers are or ... the careers of all others involved. , On Monday, March 21st, 2017 Laurie ... of Fame. The induction took place during the World of Modular – Award Gala ...
(Date:3/23/2017)... ... ... March is National Kidney Month – the perfect time to pause and thank ... Every day, two kidneys filter about 120 to 150 quarts of blood. Put another ... regulating fluid levels and blood pressure, supporting bone health and promoting red blood cell ...
Breaking Medicine News(10 mins):
(Date:3/24/2017)... DUBLIN , Mar 24, 2017 Research ... in Drug Discovery and Diagnostics, 2017 - 2035" report to ... The ... current landscape and future outlook of the growing market of deep ... data revolution, deep learning algorithms have emerged as a novel solution ...
(Date:3/24/2017)... , Mar 24, 2017 Research and Markets ... Global Strategic Business Report" report to their offering. ... The report provides separate comprehensive analytics for ... Europe , Asia-Pacific , ... are provided for the period 2015 through 2022. Also, a six-year historic ...
(Date:3/24/2017)... , March 23, 2017  Mirabilis Medical, a ... medical technology for non-invasive surgery, announced today CE ... for treatment of uterine fibroids throughout the European ... received approval from the US Food and Drug ... Mirabilis System in the United States.  The Mirabilis ...
Breaking Medicine Technology: