Objective To investigate the impact of door-to-balloon (D2B) time delay on revascularization efficacy and the dynamic changes of myocardial enzyme levels in patients with acute anterior myocardial infarction (AMI). Methods A retrospective analysis was conducted on 105 patients diagnosed with acute anterior wall myocardial infarction (AMI) who were admitted to our hospital and underwent percutaneous coronary intervention (PCI) between July 1, 2022, and June 30, 2024. Patients were evenly assigned to three groups (n=35 per group) based on the time from first medical contact to balloon inflation (door-to-balloon time, D2B): Group A (D2B ≤60 minutes), Group B (60 minutes <D2B≤120 minutes), and Group C (D2B>120 minutes). Post-treatment comparisons among the groups included clinical efficacy, success rate of coronary revascularization, time to symptom relief, and length of hospital stay. Serial measurements of myocardial enzyme levels—creatine kinase (CK) and creatine kinase isoenzyme-MB (CK-MB) —were performed at 6, 12, 24, and 72 hours after PCI to evaluate dynamic changes in myocardial injury. In addition, cardiac function was assessed using left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and left ventricular end-diastolic volume (LVEDV). The incidence of adverse cardiac events was also recorded and compared across the three groups. Results Group A demonstrated a significantly higher overall efficacy rate (94.29%) compared to Group B (77.14%) and Group C (71.43%). The success rate of revascularization in Group A (97.14%) was also significantly greater than in Groups B (82.86%) and C (77.14%). Time to symptom relief and hospital stay were notably shorter in Group A. Baseline CK and CK-MB levels showed no significant differences among the groups; however, at 6, 12, 24, and 72 hours post-treatment, levels in Group A were significantly lower than in the other groups. All groups showed improvement in LVEF after treatment, with the greatest increase observed in Group A. Additionally, reductions in LVEDV and LVESV were most pronounced in Group A. The incidence of adverse events in Group A was 2.86%, compared with 8.57% in Group B and 22.86% in Group C. The differences between groups were not statistically significant. Conclusion Shorter D2B time is associated with better clinical outcomes in patients with acute anterior AMI undergoing PCI. Prompt intervention significantly enhances revascularization success.
Key words
acute anterior myocardial infarction /
door-to-balloon time /
percutaneous coronary intervention /
myocardial enzyme markers /
cardiac function
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