# Door-to-Balloon Time vs. Total Ischemic Time as Predictors of Mortality in ST-Segment Elevation Myocardial Infarction (STEMI) Patients

## TL;DR

This study examines cardiovascular disease patterns in Pakistan, identifying risk factors and outcomes to guide better prevention and treatment strategies.

## Contribution

The study provides new insights into clinical characteristics and outcomes of cardiovascular patients in two major Pakistani centers.

## Key findings

- Hypertension, diabetes, and smoking were the most common risk factors among patients.
- ST-elevation myocardial infarction was the predominant subtype of acute coronary syndrome.
- Advanced age and multiple risk factors were significantly linked to adverse outcomes.

## Abstract

Background

Cardiovascular diseases remain a major cause of morbidity and mortality in Pakistan. Early identification of high-risk individuals is essential for improving outcomes.

Objective

To evaluate clinical characteristics, risk factors, and outcomes among patients presenting with cardiovascular conditions at two major tertiary care centers in Pakistan.

Materials and methods

This prospective observational two-center study in Pakistan was conducted at Mardan Medical Complex (Mardan) and Peshawar General Hospital (Peshawar) from January 2022 to December 2023. A total of 2,530 patients were enrolled (mean age 58.42 ± 11.36 years), including 1,964 males (77.66%) and 566 females (22.34%). Demographic data, comorbidities, clinical presentation, laboratory parameters, management strategies, and outcomes were collected and analyzed.

Results

Hypertension, diabetes mellitus, and smoking were the most prevalent comorbidities. Most patients presented with acute coronary syndromes, with ST-elevation myocardial infarction being the predominant subtype. Early revascularization, including primary percutaneous coronary intervention (PCI), was performed when indicated. Mortality and complication trends were comparable across both centers. Advanced age and multiple cardiovascular risk factors were significantly associated with adverse outcomes.

Conclusion

This prospective two-center study provides meaningful insight into the cardiovascular disease burden in Pakistan. The findings highlight the need for improved preventive strategies, timely diagnosis, and better risk-factor management to reduce cardiovascular morbidity and mortality.