Ischemic Time VS Door-To-Balloon Time as A Predictor for Mortality in ST-Elevation Myocardial Infarction

Background: Timely reperfusion is critical in ST-segment-elevation myocardial infarction (STEMI). Current guidelines for STEMI recommend early revascularization with first medical contact to coronary intervention is <120 min and door-to-balloon (D2B) time between 60-90 mins depending on presentation to a PCI or non-PCI capable hospital. However, this narrow focus does not consider the substantial duration of myocardial ischemia that exists prior to first medical contact. Several experimental studies have confirmed that infarct size and mortality are correlated with the total ischemic time (IT), that is the time from chest pain to coronary intervention.