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:6/26/2016)... Birmingham, Lake Orion, Clarkston, Michigan (PRWEB) , ... ... ... their direction with respect to fertility once they have been diagnosed with endometriosis. ... for tolerable intercourse but they also require a comprehensive approach that can help ...
(Date:6/25/2016)... Lewisville, TX (PRWEB) , ... June 25, 2016 , ... ... in the United States, named Dr. Sesan Ogunleye, as the Medical Director of its ... be the facility Medical Director of our new Mesquite location,” said Dr. James M. ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published June ... with. The article goes on to state that individuals are now more comfortable seeking ... common operations such as calf and cheek reduction. The Los Angeles area medical group, ...
(Date:6/24/2016)... MIAMI, Fla. (PRWEB) , ... June 24, 2016 , ... ... Florida Trend magazine’s 2016 Legal Elite. The attorneys chosen by their peers for this ... of Florida. , Seven Greenberg Traurig Shareholders received special honors as members of this ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB Medicine ... Making in Emergency Medicine conference in Ponte Vedra Beach, FL. The awards honor ... Emergency Medicine Practice and Pediatric Emergency Medicine Practice. , “With this ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 2016 Any dentist who has made an implant ... process. Many of them do not even offer this as ... high laboratory costs involved. And those who ARE able to ... a high cost that the majority of today,s patients would ... Parsa Zadeh , founder of Dental Evolutions Inc. and inventor ...
(Date:6/23/2016)... Capricor Therapeutics, Inc. ... company focused on the discovery, development and commercialization ... in its ongoing randomized HOPE-Duchenne clinical trial (Halt ... its 24-patient target. Capricor expects the trial to ... 2016, and to report top line data from ...
(Date:6/23/2016)... June 23, 2016  Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations ... Latin America . ... ... ... ...
Breaking Medicine Technology: