Effects of Door-In to Door-Out Time on Mortality Among ST-Segment Elevation Myocardial Infarction Patients Transferred for Primary Percutaneous Coronary Intervention - Systematic Review and Meta-Analysis.
Effects of Door-In to Door-Out Time on Mortality Among ST-Segment Elevation Myocardial Infarction Patients Transferred for Primary Percutaneous Coronary Intervention - Systematic Review and Meta-Analysis.
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门口到门口的影响对用于原发性经皮冠状动脉介入式干预的ST段抬高心肌梗塞患者的死亡率 - 系统审查和荟萃分析。
DOI：
10.1253/circrep.cr-21-0160
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发表时间：
2022-03-10
期刊：
影响因子：
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通讯作者：
Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on Behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee
中科院分区：
文献类型：
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作者：
Yamaguchi J;Matoba T;Kikuchi M;Minami Y;Kojima S;Hanada H;Mano T;Nakashima T;Hashiba K;Yamamoto T;Tanaka A;Matsuo K;Nakayama N;Nomura O;Tahara Y;Nonogi H;Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on Behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee
背景：经皮冠状动脉介入治疗st段抬高型心肌梗死（STEMI）已被广泛接受。最近的指南关注于总缺血时间，因为总缺血时间越短，预后越好。从进门到出门（DIDO）时间，定义为从到达非pci医院到离开pci医院的时间，可能影响STEMI患者的预后。然而，缺乏相关的元分析。方法和结果：我们在PubMed检索了比较DIDO时间≤30与bbb30 min的STEMI患者接受初级PCI治疗的短期（30天和住院）死亡率的临床研究。两名调查人员独立筛选了搜索结果并提取了数据。随机效应估计量的权重由反方差法计算，用于确定合并风险比。检索检索了1260项研究；其中，2项回顾性队列研究（15596例患者）进行了分析。在DIDO时间≤30和bbb30 min组中，主要终点（即住院或30天死亡）分别发生在1,794例患者中的51例（2.8%）和13,802例患者中的831例（6.0%）。DIDO时间≤30 min组的主要终点发生率显著降低（优势比0.45；95%可信区间0.34-0.60）。结论：我们的研究结果表明，DIDO时间≤30分钟与较低的短期死亡率相关。然而，需要进一步更大规模的系统综述和荟萃分析来验证我们的发现。
Background: Primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is now widely accepted. Recent guidelines have focused on total ischemic time, because shorter total ischemic time is associated with a more favorable prognosis. The door-in to door-out (DIDO) time, defined as time from arrival at a non-PCI-capable hospital to leaving for a PCI-capable hospital, may affect STEMI patient prognosis. However, a relevant meta-analysis is lacking. Methods and Results: We searched PubMed for clinical studies comparing short-term (30-day and in-hospital) mortality rates of STEMI patients undergoing primary PCI with DIDO times of ≤30 vs. >30 min. Two investigators independently screened the search results and extracted the data. Random effects estimators with weights calculated by the inverse variance method were used to determine pooled risk ratios. The search retrieved 1,260 studies; of these, 2 retrospective cohort studies (15,596 patients) were analyzed. In the DIDO time ≤30 and >30 min groups, the primary endpoint (i.e., in-hospital or 30-day mortality) occurred for 51 of 1,794 (2.8%) and 831 of 13,802 (6.0%) patients, respectively. The incidence of the primary endpoint was significantly lower in the DIDO time ≤30 min group (odds ratio 0.45; 95% confidence interval 0.34–0.60). Conclusions: Our findings suggest that a DIDO time ≤30 min is associated with a lower short-term mortality rate. However, further larger systematic reviews and meta-analyses are needed to validate our findings.