Abstract
ObjectivesTo evaluate the procedural and clinical outcomes of a new primary percutaneous coronary intervention (PPCI) centre without surgical back-up (off-site PCI) and to investigate whether these results are comparable with a high volume on-site PCI centre in the Netherlands.BackgroundControversy remains about the safety and efficacy of PPCI in off-site PCI centres.MethodsWe retrospectively analysed clinical and procedural data as well as 6‑month follow-up of 226 patients diagnosed with ST-elevated myocardial infarction (STEMI) who underwent PPCI at VieCuri Medical Centre Venlo and 115 STEMI patients who underwent PPCI at Catharina Hospital Eindhoven.ResultsPPCI patients in VieCuri Medical Centre had similar procedural and clinical outcomes to those in Catharina Hospital. Overall there were no significant differences. The occurrence of procedural complications was low in both groups (8.4 % VieCuri vs. 12.3 % Catharina Hospital). In the VieCuri group there was one procedural-related death. No patients in either group needed emergency surgery. At 30 days, 17 (7.9 %) patients in the VieCuri group and 9 (8.1 %) in the Catharina Hospital group had a major adverse cardiac event.ConclusionPerforming PPCI in an off-site PCI centre is safe and effective. The study results show that the procedural and clinical outcomes of an off-site PPCI centre are comparable with an on-site high-volume PPCI centre.
Highlights
Primary percutaneous coronary intervention (PPCI) at hospitals without surgical back-up has been frequently investigated and debated
The knowledge that a decrease in time to reperfusion leads to decreased infarct size and incidence of major adverse cardiac events (MACE), contributed to the rise of off-site PCI centres [2, 4,5,6]
A total of 122 and 237 PPCIs in patients diagnosed with ST-elevated myocardial infarction (STEMI) were conducted in Catharina Hospital and VieCuri, respectively
Summary
Primary percutaneous coronary intervention (PPCI) at hospitals without surgical back-up (off-site PCI) has been frequently investigated and debated. The mortality rates for patients requiring emergency surgery are the same in off-site and on-site PPCI centres [17, 18]. No distinction is made between onsite and off-site centres while, according to the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines, PPCI at off-site centres is a class IIa indication [19]. Both the ESC and ACC recommend that. Controversy remains about the safety and efficacy of PPCI in off-site PCI centres
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