Primary percutaneous coronary intervention for the treatment of acute ST-segment elevated myocardial infarction: Initial single-center experience from Kathmandu, Nepal

Abstract

Introduction: Primary percutaneous coronary intervention (PPCI) has become the preferred initial revascularization strategy in patients with acute ST-segment elevation myocardial infarction (STEMI). This study aims to find out the clinical profile and in-hospital outcomes of initial 100 patients undergoing PPCI in a newly established cath laboratory at Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu, Nepal. Methodology: This is an observational study including initial 100 cases treated with PPCI at Manmohan Cardiothoracic Vascular and Transplant Center starting from September 2012. All patients with STEMI arriving at the hospital within recommended period were included in the study. Data on safety and outcome were obtained and analyzed from records of the emergency room, cath laboratory, coronary care unit, and discharge records. Results: The mean age of the study population was 52.5 ± 13.5 years. Of the total patients, 41% presented with anterior wall MI, 51% presented with inferior wall MI, and 5% had true posterior MI. Single-vessel disease was seen in 59%. Left anterior descending artery was the most common culprit vessel (43%). Mean window period and door-to-balloon time were 8 ± 3.15 h and 59 ± 11.25 min, respectively. Drug-eluting stents were deployed in 82% of the cases. In our study, in-hospital mortality was 3%. Conclusion: PPCI can be an initial strategy to treat STEMI even at a newly established cardiac center if it is performed by a dedicated team with an experienced operator within recommended period.