Abstract
INTRODUCTION: The most effective therapy for ST-segment elevation myocardial infarction (STEMI) is immediate primary percutaneous coronary intervention (pPCI). AIM: We planned this study to evaluate the effect of emergency department delay time (EDDT) on in-hospital and 1-year all-cause mortality in STEMI patients who underwent pPCI. MATERIAL AND METHODS: Between October 2016 and May 2021, we examined 890 consecutive STEMI patients who had pPCI at our institution within 12 h of the onset of symptoms. The clinical endpoint of this study was in-hospital and 1-year all-cause mortality. RESULTS: The cohort mostly comprised men (690 [77.5]), and their mean age was 60.7 ±13.5 years. The median EDDT was 23 (15-35) min, sheath-to-balloon (STB) time was 10 (7-13) min, and door-to-balloon (DTB) time was 34 (25-48) min. In multivariable logistic regression analysis EDDT (OR = 0.994; CI = 0.972-1.017; p = 0.611) was not a predictor for in-hospital mortality. In the multivariable Cox regression analysis, EDDT (HR = 1.011, CI = 1.002-1.021, p = 0.022), age (HR = 1.044, CI = 1.019-1.068, p < 0.001), left ventricle ejection fraction (HR = 0.957, CI = 0.931-0.988, p = 0.003), and glomerular filtration rate (HR = 0.982, CI = 0.966-0.997, p = 0.016) were the independent predictors of 1-year all-cause death across all causes. CONCLUSIONS: We found that EDDT was an independent predictor among all causes for 1-year mortality in STEMI patients who underwent pPCI but not in-hospital mortality. Reducing the time spent in the emergency department as much as possible may reduce mortality rates.