A guideline based approach of percutaneous coronary intervention in acute myocardial infarction: Single center experience

Abstract

To determine the outcomes of percutaneous coronary intervention (PCI) in patients presenting with ST-segment elevation myocardial infarction (STEMI) according to PCI guidelines. This study was conducted between January 2008 and December 2010. A total of 450 patients presenting with STEMI underwent PCI: 288 patients underwent primary PCI, and 162 patients underwent non-primary PCI. The mean age at presentation was 55 ± 11.10 years and 89.8% were male. The door-to-balloon time was 60 min in primary PCI group (288 patients). The median time between end of failed thrombolytic therapy and the rescue PCI was 420 min (95 patients) versus 810 min after successful thrombolytic therapy (35 patients). Only 32 patients underwent late PCI ⩾ 24 h and ⩽48 h without thrombolytic therapy; median time was 2160 min. In-hospital, 30 days and 6-months mortality were respectively 2.1%, 0.7% and 1.1% in primary PCI group while 2.5%, 3.2% and 2.6% in non-primary PCI group. In-hospital, 30 days and 6-months reinfarction occurred in 0.3%, 1.1% and 0.7% of patients in primary PCI group while 0.0%, 1.3% and 0.7% in non-primary PCI group respectively. In-hospital, 30 days and 6-months TVR occurred in 0.7%, 0.7% and 1.1% of patients in primary PCI group while 0.0%, 1.3% and 0.7% in non-primary PCI group respectively. This is the first report from Egyptian hospital to provide a comprehensive review of patient characteristics and outcomes of PCI for STEMI. We reported a high initial success rate, excellent short and intermediate-term outcomes.