AN UPDATE ON PROCEDURAL OUTCOMES OF PRIMARY PERCUTANEOUS CORONARY INTERVENTIONS (PCI) IN PATIENTS WITH ST SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) AND ITS IMPACT ON INHOSPITAL MORTALITY AT A TERTIARY CARDIAC CARE CENTER
Keywords:
Primary percutaneous coronary intervention (P.PCI), ST segment elevation myocardial infarction (STEMI)Abstract
Objective: To determine the primary and secondary outcomes of primary percutaneous coronary interventions (PCI) in ST segment elevation myocardial infarction and to measure the success rate of primary PCI procedure at AFIC/NIHD.
Study Design: A descriptive cross-sectional study.
Materials and Methods: The study was conducted in the Cardiology department of AFIC/NIHD, a tertiary care cardiac institute at Rawalpindi. The data was collected from an ongoing registry. It is an update on procedural outcome of PPCI over the 4 year duration from October 2011 to January 2016. Total 2136 patients who underwent primary PCI were included in this study. Procedural outcome, success and in hospital mortality were notable variables.
Results: The mean age was 59 ± 10.88 years. Patients of age group 58-75 and above 75 year were having high mortality rate of 2.1% and 2.5% respectively (p-value<0.783). There were 1975 (92.3%) males and 164 (7.7%) female. 378 (17.6%) patients were found to be diabetic (p<0.554), 608 (28.4%) hypertensive (p<0.736), and 637 (29.7%) patients were smokers (p<0.868). Family history of ischemic heart disease was positive in 323 (15.1%) patients, which is a significant factor with the p-value=0.028. Anterior, inferior and lateral myocardial infarction was present in 1116 (53.8%), 920 (44.3%) and 19 (0.9%) patients respectively (p<0.800). The Median time from the onset of symptoms to the arrival in the hospital was 210 ± 562.8 min (p< 0.001) and median door to balloon time was 56.25 ± 2.6 min (p<0.566). Left anterior descending (LAD) was the culprit artery in 1115 (56.1%) patients followed by right coronary artery (RCA) 659 (33.2%) & left circumflex artery (LCX) in 174 (8.8%) cases (p<0.001). 44 (2.1%) patients died in the hospital.
Conclusion: High success rate with low mortality rates can be achieved in our set up. However more studies and long term follow up is required to validate our results.
