Emergency Chest Pain Center: A Novel Approach to Reduce Door to Balloon Time

JACC AdvPublished 13 May 2025prospective review of consecutive patients

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Authors' conclusion

Implementation of an ED catheterization lab is a feasible strategy which may reduce D2B and STEMI mortality.

Study context

Population: Consecutive patients presenting with STEMI between 1998 and 2011 and treated with primary percutaneous coronary interventionEmergency department (ED) 553 · standard catheterization labs 500
Participants: 1,053 STEMI patients

Exposure: STEMI patients presenting to ED vs standard catheterization labs
ED catheterization labn = 553
Standard catheterization labn = 500reference
Outcome: D2B and time to death

Methodological detailscommunity hospital, multivariable linear regression, Cox proportional hazards model

As reported in the abstract

ED catheterization lab54minutes

Standard catheterization lab83minutes

ED catheterization lab vs standard catheterization labAdj HR (95% CI)

30-day mortality

0.54(0.29–0.99)

1-year mortality

0.58(0.37–0.91)

10-year mortality

0.39(0.29–0.53)

Observational data: associations, not effects.

Left ventricular ejection fraction <40%

ED catheterization lab6.5%

Standard catheterization lab11%

Outcome	ED catheterization lab	Standard catheterization lab
<30-minute D2B	17%	<1%

Baseline characteristics

Both groups had similar age, sex, race, diabetes, left main disease, and Killip class on presentation

Emergency Chest Pain Center: A Novel Approach to Reduce Door to Balloon Time. JACC Adv. Published 13 May 2025. doi:10.1016/j.jacadv.2025.101774

Summarised from the published abstract; every number is checked against it