What is the door-to-balloon time target for STEMI reperfusion with PCI?

• A. 60 minutes or less from first medical contact to balloon
• B. 90 minutes or less from first medical contact to balloon
• C. 120 minutes or less from first medical contact to balloon
• D. 150 minutes or less from first medical contact to balloon

Answer: (B)

In STEMI, saving myocardium hinges on getting reperfusion as quickly as possible, because every minute of delay increases heart tissue loss and worsens survival. The key measure is from the moment a patient first comes into contact with a medical professional (EMS or hospital staff) to the moment the PCI balloon is inflated in the cath lab. The standard target for this door-to-balloon interval is 90 minutes or less. This 90-minute goal reflects evidence showing markedly better outcomes when PCI is performed within that window, balancing the urgency with the realities of organizing rapid activation, transport, and cath lab readiness. Times substantially shorter than 90 minutes would be ideal but are not consistently achievable in many systems, while delays extending beyond 90 minutes correlate with greater infarct size and higher mortality. Therefore, aiming for 90 minutes or less from first medical contact to balloon is the best, most evidence-supported target for PCI reperfusion in STEMI.