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:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs surgery services, can now ... and to Dr. Russell Peckham for medical and surgical dermatology. , Dr. Dorsey brings ... The selective fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was under the ...
(Date:6/25/2016)... Oklahoma (PRWEB) , ... June 25, 2016 , ... ... both athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures ... Oklahoma City area —Johnson is one of the first doctors to perform the ...
(Date:6/24/2016)... ... June 24, 2016 , ... June 19, 2016 is World Sickle ... chronic pain and the benefits of holistic treatments, Serenity Recovery Center of ... Sickle Cell Disease. , Sickle Cell Disease (SCD) is a disorder of the red ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, ... and the Road To Recovery® program to drive cancer patients to and from their ... to ensure the highest quality of life and ongoing independence. Getting to and ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... client, The Grove Investment Group (TGIG), has initiated cultivation and processing operations at ... Las Vegas and Pahrump, Nevada. , Puradigm is the manufacturer of a complete ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 Dehaier Medical Systems ... "Company"), which develops, markets and sells medical devices and ... , signed a strategic cooperation agreement with Hongyuan Supply ... Supply Chain") on June 20, 2016, to develop Dehaier,s ... strategic cooperation agreement, Dehaier will leverage Hongyuan Supply Chain,s ...
(Date:6/24/2016)... Mass. , June 24, 2016   Pulmatrix, ... pharmaceutical company developing innovative inhaled drugs, announced today that ... Russell Investments reconstituted its comprehensive set of ... "This is an important milestone for Pulmatrix," ... will increase shareholder awareness of our progress in developing ...
(Date:6/23/2016)... Research and Markets has announced the addition of the ... report to their offering. ... failure, it replaces the function of kidneys by removing the ... the treatment helps to keep the patient body,s electrolytes such ... Increasing number of ESRD patients & substantial healthcare expenditure on ...
Breaking Medicine Technology: