Predicting treatment outcomes by door-to-device time and baseline characteristics in STEMI patients undergoing PPCI: a cross-sectional study in southern Iran.

IF 0.6 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

ARYA Atherosclerosis Pub Date : 2026-01-01 DOI:10.48305/arya.2025.45242.3055

Sajad Vosoughi, Mohammad Adineh, Ali Kardooni, Mehrnaz Ahmadi, Saeed Ghanbari

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Abstract

Background: Primary percutaneous coronary intervention (PPCI) is considered the gold standard for ST-elevation myocardial infarction (STEMI) treatment. While door-to-device (DTD) time critically influences outcomes, its combined impact with baseline characteristics requires further investigation.

Methods: In this descriptive cross-sectional analytical study, 163 patients with STEMI undergoing PPCI were recruited through convenience sampling at two hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences between November 2024 and May 2025. Data were collected via hospital records and a researcher-designed checklist covering demographic and clinical variables. Statistical analyses were performed using SPSS version 26.

Results: The mean age of participants was 57.55 ± 13.19 years, and 85.9% were male. The mean DTD time was 108.08 minutes. Longer DTD time was significantly associated with prolonged CCU stay (r = 0.335, p < 0.001) and lower left ventricular ejection fraction (LVEF) (r = -0.232, p = 0.003). Although DTD time did not differ significantly between survivors and non-survivors (p = 0.573), it varied significantly across different degrees of myocardial injury (p = 0.027). Multivariate regression analysis showed that male gender (β = -8.007, p = 0.002), increased DTD time (β = -0.043, p = 0.005), and myocardial injury (β = -14.904, p = 0.016) were significantly associated with reduced LVEF. Increased DTD time (β = 0.014, p < 0.001) and decreased LVEF (β = -0.061, p = 0.003) were significantly associated with longer CCU stays.

Conclusion: While baseline characteristics showed minimal impact, DTD time significantly predicted worse outcomes, including prolonged CCU stays, reduced LVEF, and myocardial injury. These findings emphasize the critical importance of reducing DTD time (<60 minutes) through optimized emergency protocols to improve STEMI management outcomes.

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通过门到装置时间和基线特征预测接受PPCI的STEMI患者的治疗结果：伊朗南部的一项横断面研究。

背景：原发性经皮冠状动脉介入治疗（PPCI）被认为是st段抬高型心肌梗死（STEMI）治疗的金标准。虽然门到设备（DTD）时间对结果有关键影响，但其与基线特性的综合影响需要进一步研究。方法：在这项描述性横断面分析研究中，通过方便抽样，于2024年11月至2025年5月在Ahvaz Jundishapur医科大学附属的两家医院招募了163名接受PPCI的STEMI患者。通过医院记录和研究人员设计的涵盖人口统计学和临床变量的检查表收集数据。采用SPSS 26进行统计分析。结果：参与者平均年龄57.55±13.19岁，男性占85.9%。平均DTD时间为108.08分钟。延长DTD时间与延长CCU住院时间（r = 0.335, p < 0.001）和降低左室射血分数（LVEF）（r = -0.232, p = 0.003）显著相关。虽然存活者与非存活者之间的DTD时间差异不显著（p = 0.573），但不同程度心肌损伤之间的DTD时间差异显著（p = 0.027）。多因素回归分析显示，男性（β = -8.007, p = 0.002）、DTD时间增加（β = -0.043, p = 0.005）、心肌损伤（β = -14.904, p = 0.016）与LVEF降低有显著相关性。延长DTD时间（β = 0.014, p < 0.001）和降低LVEF （β = -0.061, p = 0.003）与延长CCU住院时间显著相关。结论：虽然基线特征的影响很小，但DTD时间显著预测更差的结果，包括CCU停留时间延长、LVEF降低和心肌损伤。这些发现强调了减少DTD时间(

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