Coronary artery diseaseEffectiveness of Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction from a 5-Year Single-Center Experience
Section snippets
Methods
The study was conducted at the University Medical Center Ljubljana from January 1, 2000, to December 31, 2004. Patients with STEMI2, 3 presenting within 12 hours after the onset of symptoms (or later in case of ongoing discomfort) who underwent urgent coronary angiography and primary PCI were compared with a historic control group consisting of consecutive patients with STEMI who underwent thrombolysis from July 1, 1995, to June 30, 1996. These patients were selected from a group of 345
Results
During a 5-year study period, 2,393 patients with an evolving STEMI were treated in our hospital (Table 1). Most patients (81%) were admitted through the emergency department. The proportion of patients transferred directly to the catheterization laboratory from 9 non-PCI hospitals (distance 36 to 121 km, median 74) increased to 21% in 2004. This was true also for patients transferred directly from 31 prehospital emergency units/outpatient clinics (distance 22 to 140 km, median 47), for whom
Discussion
Our study described a large single-center experience with the introduction of primary PCI in unselected patients with STEMI, including those with resuscitated cardiac arrest and severe heart failure on admission. The proportion of patients with STEMI who underwent primary PCI in our hospital linearly increased to 84% with a concomitant decrease in the use of rescue and ischemia-driven PCI, as well as thrombolysis. These trends reflected a shift toward timely and more effective acute reperfusion
Acknowledgment
The authors recognize the contribution of the interventional cardiology team (Marko Gricar, MD, Igor Kranjec, MD, PhD, Hrvoje Reschner, MD, Radovan Starc, MD, PhD, Matjaz Sinkovec, MD, PhD, and Igor Zupan, MD, PhD) and intensive care unit team (Hugon Mozina, MD, Andrej Pernat, MD, PhD, Dusan Stajer, MD, PhD, and Tom Ploj, MD, PhD).
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