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The final study population consisted of 629 adult residents of central Massachusetts who were hospitalized with STEMI and received a primary PCI at the two major PCI-capable urban teaching and community hospitals in the Worcester metropolitan area on a biennial basis between 2001 and 2011. Overall, the average age of this patient population was 61.9 years; 30.5% were women, 91.7% were White, and 62.0% were married. In addition, 75.8% of our study sample was hospitalized for an initial AMI, 75.9% were transported to the study hospitals by ambulance, and 53.1% arrived at participating EDs during off-hours CX-5461 order (Table 1). Table 1 Characteristics of patients who were hospitalized with STEMI and received a primary PCI: Worcester Heart Attack Study During the most recent years under study, patients who were hospitalized with STEMI and received a primary PCI were more likely to have a history of peripheral vascular disease or have prior coronary revascularization, compared to those hospitalized with STEMI during earlier study periods (Table 1). Trends in door-to-balloon time The average delay time from the patient��s arrival at the ED to inflation of the balloon to restore coronary flow during the years under study was 102 minutes. There was a marked decrease in the mean delay time from 2001/2003 (141 minutes) to 2009/2011 (85 minutes) (Figure 1). The median delay time from the patient��s arrival at the hospital ED to balloon inflation during the years under study was 89 minutes. There was also a significant decrease this website in the median duration of PCI-associated delay from 2001/2003 (133 minutes) to 2009/2011 (73 minutes) (Figure 1). Figure 1 Trends in door-to-balloon time among patients hospitalized with ST-segment elevation myocardial infarction: Worcester Dipivefrine Heart Attack Study. Among all study patients who underwent a primary PCI, 50.9% of these patients received the intervention within 90 minutes of their arrival at the ED. There was a dramatic increase in the proportion of patients with STEMI who received a primary PCI within guideline-recommended 90 minutes between 2001/2003 (17.2%) and 2009/2011 (70.5%) (P for trend