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Revista argentina de cardiología

versión On-line ISSN 1850-3748


FURMENTO, Juan et al. Optimization of Door-to-Balloon Time Implementing a Process Improvement Program. Results after 5 Years. Rev. argent. cardiol. [online]. 2023, vol.91, n.2, pp.218-222. ISSN 1850-3748.


If available, primary transluminal coronary angioplasty (PTCA), performed timely and in experienced sites, is the best reperfusion strategy for ST elevation myocardial infarction (STEMI). The door-to-balloon (DTB) time expresses operational efficiency of the site in charge of the PTCA, with an impact on patient’s progress. The aim of this study was to analyze the long-term results of a continuous improvement program for the DTB time process.


Patients diagnosed with STEMI who had undergone PTCA from January 2015 to May 2022 were prospectively and consecutively enrolled. The population was divided in two periods: an immediate implementation period and a long-term follow-up period.


671 patients were prospectively and consecutively enrolled. During the implementation period (P1) 91 patients were enrolled, and 580 during the program follow-up (P2). The median (interquartile range, IQR) DTB time was 46 min (29-59) for P1 vs 42 min (25-52) for P2, p=0.055). The second period showed a reduction in pre-activations (P1 54,1% vs P2 30 %, p=0.02) and on-hour procedures (42% for P1 versus 30% for P2, p=0.029).


The registry showed long-term maintenance of good results, despite reduced reactivations and on-hour procedures.

Palabras clave : Myocardial Infarction; Angioplasty; Time-to-Treatment; Infarto del miocardio; Angioplastia; Tiempo de tratamiento.

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