FACTORS ASSOCIATED WITH DOOR-TO-BALLOON TIME AND CLINICAL OUTCOMES IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PCI AT HUA HIN HOSPITAL

Abstract

     ST-elevation myocardial infarction (STEMI) is a time-sensitive condition where prompt treatment is crucial, with Door-to-Balloon (D2B) time serving as a critical quality indicator. This study aimed to investigate factors associated with a D2B time exceeding 90 minutes and to analyze its association with clinical outcomes. A retrospective analytical study was conducted using medical records from 304 STEMI patients who underwent Primary Percutaneous Coronary Intervention (Primary PCI) at Hua Hin Hospital between January 1, 2024, and December 31, 2025. Data were analyzed using descriptive statistics, Chi-square test, independent t-test, and binary logistic regression.

     The results indicated that 57.2% of patients experienced a D2B time exceeding 90 minutes. Factors significantly associated with treatment delay included arrival during off-hours (p < 0.001) and prolonged times at each step of the emergency department process (p < 0.001). Patient-related factors did not show a significant association. The group with a D2B time > 90 minutes had significantly higher in-hospital mortality (12.1% vs. 4.6%, p = 0.021) and a higher incidence of acute heart failure (23.6% vs. 10.8%, p = 0.004) compared to the on-time group.

     The study concludes that service system factors, particularly off-hour readiness, are critical determinants of treatment delays and adverse clinical outcomes. Therefore, improving internal hospital workflows is imperative to enhance the quality of care and reduce patient mortality.