{"doi":"10.1161/circinterventions.120.009879","title":"Time Delay, Infarct Size, and Microvascular Obstruction After Primary Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction","abstract":"BACKGROUND: Symptom-to-balloon time (SBT) and door-to-balloon time (DBT) are both considered important metrics in patients undergoing primary percutaneous coronary intervention (pPCI) for ST-segment-elevation myocardial infarction (STEMI). We sought to assess the relationship of SBT and DBT with infarct size and microvascular obstruction (MVO) after pPCI. METHODS: Individual patient data for 3115 ST-segment-elevation myocardial infarction patients undergoing pPCI in 10 randomized trials were pooled. Infarct size (% left ventricular mass) was assessed within 1 month after randomization by technetium-99 m sestamibi single-photon emission computerized tomography (3 studies) or cardiac magnetic resonance imaging (7 studies). MVO was assessed by cardiac magnetic resonance. Patients were stratified by short (≤2 hours), intermediate (2-4 hours), or long (>4 hours) SBTs, and by short (≤45 minutes), intermediate (45-90 minutes), or long (>90 minutes) DBTs. RESULTS: Median [interquartile range] SBT and DBT were 185 [130-269] and 46 [28-83] minutes, respectively. Median [interquartile range] time to infarct size assessment after pPCI was 5 [3-12] days. There was a stepwise increase in infarct size according to SBT category (adjusted difference, 2.0% [95% CI, 0.4-3.5] for intermediate versus short SBT and 4.4% [95% CI, 2.7-6.1] for long versus short SBT) but not according to DBT category (adjusted difference, 0.4% [95% CI, -1.2 to 1.9] for intermediate versus short DBT and -0.1% [95% CI, -1.0 to 3.0] for long versus short SBT). MVO was greater in patients with long versus short SBT (adjusted difference, 0.9% [95% CI, 0.3-1.4]) but was not different between patients with intermediate versus short SBT (adjusted difference, 0.1 [95% CI, -0.4 to 0.6]). There was no difference in MVO according to DBT. Results were similar in multivariable analysis with SBT and DBT included as continuous variables. CONCLUSIONS: Among 3115 patients with ST-segment-elevation myocardial infarction undergoing infarct size assessment after pPCI, SBT was more strongly correlated with infarct size and MVO than DBT.","journal":"Circulation Cardiovascular Interventions","year":2021,"id":152996,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":71,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9675,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":649476,"name":"Reza Mohebi","orcid":"0000-0002-6744-3119","position":1,"is_corresponding":false},{"id":352800,"name":"Gennaro Giustino","orcid":"0000-0002-5400-9516","position":2,"is_corresponding":false},{"id":649477,"name":"Shmuel Chen","orcid":"0000-0001-8843-1777","position":3,"is_corresponding":false},{"id":89361,"name":"Harry P. Selker","orcid":"0000-0001-5322-7178","position":4,"is_corresponding":false},{"id":50984,"name":"Holger Thiele","orcid":"0000-0002-0169-998X","position":5,"is_corresponding":false},{"id":302877,"name":"Manesh R. Patel","orcid":"0000-0002-2393-0855","position":6,"is_corresponding":false},{"id":235132,"name":"James E. Udelson","orcid":"0000-0003-2998-910X","position":7,"is_corresponding":false},{"id":369943,"name":"E. Magnus Ohman","orcid":"0000-0002-6249-4988","position":8,"is_corresponding":false},{"id":649478,"name":"Ingo Eitel","orcid":"0000-0002-6442-246X","position":9,"is_corresponding":false},{"id":260564,"name":"Christopher B. Granger","orcid":"0000-0002-0045-3291","position":10,"is_corresponding":false},{"id":249009,"name":"Akiko Maehara","orcid":"0000-0002-1910-8447","position":11,"is_corresponding":false},{"id":227161,"name":"Ziad A. Ali","orcid":"0000-0002-2482-3197","position":12,"is_corresponding":false},{"id":254522,"name":"Ori Ben‐Yehuda","orcid":"0000-0001-9199-1660","position":13,"is_corresponding":false},{"id":104011,"name":"Gregg W. Stone","orcid":"0000-0002-3416-8210","position":14,"is_corresponding":false},{"id":254523,"name":"Björn Redfors","orcid":"0000-0002-4155-4451","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-18T23:43:39.820288Z","pmid":"33440999","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}