Journal article

Re-examining the effect of door-to-balloon delay on STEMI outcomes in the context of unmeasured confounders: a retrospective cohort study

Chee Yoong Foo, Nick Andrianopoulos, Angela Brennan, Andrew Ajani, Christopher M Reid, Stephen J Duffy, David J Clark, Daniel D Reidpath, Nathorn Chaiyakunapruk

Scientific Reports | NATURE PUBLISHING GROUP | Published : 2019


Literature studying the door-to-balloon time-outcome relation in coronary intervention is limited by the potential of residual biases from unobserved confounders. This study re-examines the time-outcome relation with further consideration of the unobserved factors and reports the population average effect. Adults with ST-elevation myocardial infarction admitted to one of the six registry participating hospitals in Australia were included in this study. The exposure variable was patient-level door-to-balloon time. Primary outcomes assessed included in-hospital and 30 days mortality. 4343 patients fulfilled the study criteria. 38.0% (1651) experienced a door-to-balloon delay of >90 minutes. Th..

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