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ST<\/jats:styled-content>\u2010elevation myocardial infarction presenting >12\u2009h and rescue percutaneous coronary intervention was excluded. Major adverse cardiac events were analysed according to DTBT<\/jats:styled-content> (dichotomised as \u226490\u2009min vs >90\u2009min). A multivariable analysis for predictors of mortality (including DTBT<\/jats:styled-content>) was performed.<\/jats:p><\/jats:sec>Results<\/jats:title>Baseline demographics, clinical and procedural characteristics were similar in the STEMI<\/jats:styled-content> cohort across the 5 years, apart from an increase in out\u2010of\u2010hospital cardiac arrest (3.6% in 2006 vs 9.4% in 2010, P<\/jats:italic><\/jats:styled-content> < 0.0001) and cardiogenic shock (7.7\u20139.6%, P<\/jats:italic><\/jats:styled-content> = 0.07). The median DTBT<\/jats:styled-content> (interquartile range) was reduced from 95 (74\u2013130) min in 2006 to 75 (51\u2013100) min in 2010 (P<\/jats:italic><\/jats:styled-content> < 0.01). In this period, the proportion of patients achieving a DTBT<\/jats:styled-content> of \u226490\u2009min increased from 45% to 67% (P<\/jats:italic><\/jats:styled-content> < 0.01). Lower mortality and major adverse cardiac event rates were observed with DTBT<\/jats:styled-content> \u226490\u2009min (all P<\/jats:italic><\/jats:styled-content> < 0.01). Multivariable analysis showed that a DTBT<\/jats:styled-content> of \u226490\u2009min was associated with improved clinical outcomes at 12 months (odds ratio 0.48; 95% confidence interval 0.33\u20130.73, P<\/jats:italic><\/jats:styled-content> < 0.01).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>There has been a decline in median DTBT<\/jats:styled-content> in the M<\/jats:styled-content>elbourne I<\/jats:styled-content>nterventional G<\/jats:styled-content>roup registry over 5 years. DTBT<\/jats:styled-content> of \u226490\u2009min is associated with improved clinical outcomes at 12 months.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12405","type":"journal-article","created":{"date-parts":[[2014,3,10]],"date-time":"2014-03-10T04:36:15Z","timestamp":1394426175000},"page":"471-477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Trends in door\u2010to\u2010balloon time and outcomes following primary percutaneous coronary intervention for ST<\/scp>\u2010elevation myocardial infarction: an A<\/scp>ustralian perspective"],"prefix":"10.1111","volume":"44","author":[{"given":"A. L.","family":"Brennan","sequence":"first","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics (CCRET) Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Cardiology Alfred Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Andrianopoulos","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics (CCRET) Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Duffy","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics (CCRET) Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Cardiology Alfred Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. M.","family":"Reid","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics (CCRET) Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Cardiology Austin Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Loane","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics (CCRET) Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"New","sequence":"additional","affiliation":[{"name":"Eastern Health Clinical School Faculty of Medicine Nursing and Health Sciences Monash University Melbourne Victoria Australia"},{"name":"Department of Cardiology Box Hill Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Black","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics (CCRET) Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Cardiology Royal Melbourne Hospital Melbourne Victoria Australia"},{"name":"Department of Cardiology Geelong Hospital Geelong Victoria Australia"},{"name":"School of Medicine Deakin University Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. P.","family":"Yan","sequence":"additional","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics (CCRET) Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Medicine and Therapeutics Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Cardiology Box Hill Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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