Medida do tempo porta-balão em atendimento a infartos agudos do miocárdio com supradesnivelamento do segmento ST

Abstract

Introduction: ST-Elevation Myocardial Infarction (STEMI) is a severe clinical condition that requires rapid intervention to restore coronary blood flow. Door-to-balloon time, defined as the interval between the patient's arrival at the hospital and the performance of primary angioplasty, is an important indicator of healthcare quality. Guidelines recommend that this time should not exceed 90 minutes in hospitals with hemodynamic services. This time has a direct impact on the preservation of myocardial function and patient survival, being considered one of the main prognostic determinants in the acute phase of STEMI. Objective: To measure the average door-to-balloon time in the care of patients diagnosed with STEMI at a hospital in the northern region of Rio Grande do Sul, verify the proportion of patients treated outside the recommended timeframe and related outcomes, as well as investigate possible factors associated with the increase in door-to-balloon time. Method: A cross-sectional study conducted at a tertiary hospital located in Passo Fundo, RS, with patients who underwent primary angioplasty following STEMI from January 1 to December 31, 2024, whose data were collected from electronic medical records, which populated a database in the EpiData software, and subsequently analyzed in the PSPP software. Results: In the sample (n=136), there was a predominance of the male sex (65.4%), elderly individuals ≥60 years old (70.6%), and white skin color (94.1%). Most of the care was funded by the Sistema Único de Saúde (84.6%), with patients originating from other municipalities (72.8%). Among comorbidities and risk factors, systemic arterial hypertension (55.1%), smoking (43.4%), and diabetes mellitus (25.7%) stood out. The mean door-to-balloon time was 76 minutes, with a standard deviation of 34 minutes, and the ≤90 minutes goal was not achieved in 19.9% of cases. Conclusion: The patient profile reflects a predominantly elderly, male population with multiple cardiovascular risk factors. It was observed that the door-to-balloon time is not adequate according to guidelines in 19.9% of the cases, with the main factors in cases of delay being the unavailability of catheterization labs and the need for patient stabilization before performing the procedure.