నైరూప్య

National Heart Institute registry for ST segment elevation myocardial infarction patients managed by primary PCI.

Mohamed A. Elbordy, Abdel-Rahman G. Abdelaleem, Ahmad M. Alkonaiesy*, Abdrabo A. Hassaan, Medhat M. Elsayed, Khaled M. El-Tohamy, Laila Shalaby, Osama M. Taha, Gamal M. Shaban

Background: Little investigations addressed the results of STEMI patients managed by primary PCI in Egyptian population, especially in high volume tertiary cardiac hospital centers. The aim of the current study was to assess cardiovascular risk factors, angiographic and interventional characteristics, short term mortality and morbidity of STEMI patients undergoing PPCI presenting to our hospital.

Methods: We include all the patients admitted to our STEMI unite managed by primary PCI since November 2018 till 6 months afterwards (n=1354). We excluded patients presenting to ER with STEMI more than 48 hours, and patients with contraindication for primary PCI. We utilized angiographic characteristics, in-hospital mortality, and rates of procedural complications in all patients, being analyzed with appropriate statistical tests. Media of time to first medical contact in our ER and time to wire crossing of culprit artery were recorded and analyzed as well.

Results: Patients were young with a mean age of 54.45 and SD of 11.04, 97.5% were less than 75 years old while only 2.5% were more than 75 years old, 83.3% males and 16.7% females. The period elapsed from the onset of symptoms and the contact for medical help was longer for our patients: 120.0 (60.0; 240.0) minutes, and longer median time to wire crossing to culprit artery 95 (20.0; 170) minutes. The staff of ER was the first medical help (85% of patients). The admission mode was on the basis of individual presentation in 89% of patients. Anterior MI was found in 67.0% of cases presenting ECG. Reperfusion therapy was performed by PPCI to culprit artery in 90% of cases. In-hospital mortality was 3.9%.

Conclusion: Most of STEMI patients in our study were young males, current smokers, diabetics, showed higher prevalence of premature CAD, had significant time delays from the onset of symptoms to the contact for medical help, and more individual presenting rather than EMS presenting. Femoral access was the dominantly used access for PPCI. All stents used were drug eluting stents. Culprit only revascularization was the mainly used strategy, multi vessel disease staging intervention was done after hospital discharge. In-hospital mortality was comparable to other national registries.