Developing Primary Percutaneous Coronary Intervention- In Region In Need and Capable Hospital

Background: Early studies advocated that hospitals with lower volumes of primary PCI had higher in-hospital mortality. The allocation of ST elevation myocardial infarction (STEMI) patients for long distance and time could influence the patient`s safety during the transport and reduce the efficacy Primary PCI. We decided to build up a primary PCI facility that give adequate response in time for Primary PCI cases 24 hours a day.

Methods:

Our catheterization laboratory did not work in 24/7 manner for three years. Patients with STEMI were transferred to other PCI centers, transfer time used to be long and this delay usually impacts in the efficiency of performing Primary PCI. Our center is a medium volume with annual 800 catheterizations and fifty percent from these are PCI cases. We report here the in hospital and 30 days mortality and major adverse events of our first cases of primary PCI.

Results:

We included all cases with STEMI in first 6 months, 20 anterior, 18 inferior and 15 posterolateral MI. The procedure success was high, and complication of the procedure was very low, we used the radial approach in the majority of patients. In hospital and 30 day mortality was 0, need for emergent CABG WAS 0 and instent thrombosis was in one case.

Conclusion: Our results support that the outcomes of mortality and MACE of low to medium volume center are non-inferior to high volume center, and Primary PCI is safe and effective if carried out with adequate supervision and quality assurances in low to medium volume center. Development of new PCI-capable hospital will improve access for patients and not simply lead to duplicative services.