A retrospective cohort at one high-volume Chinese centre compared door-to-balloon times of 60 minutes or less with longer times in 4,513 STEMI patients treated by primary PCI, stratified by GRACE risk score. Among 2,433 higher-risk patients, a time over 60 minutes was associated with higher in-hospital mortality (odds ratio 2.38) and 3-year mortality (hazard ratio 1.69); no association was found in lower-risk patients.
Why it is interesting: Suggests the mortality gain from faster reperfusion is concentrated in higher-risk presentations rather than spread across all STEMI patients.