Experience of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction at a referral healthcare centre in India.
Loading...
Date
2015-11
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background. India has the highest burden of coronary
artery disease in the world. It also has a higher rate of STsegment
elevation myocardial infarction than that in developed
countries. Primary percutaneous coronary intervention is an
effective treatment, yet little is known about its feasibility and
outcome in India. We studied the outcomes of primary
percutaneous coronary intervention at an Indian tertiary care
centre.
Methods. We did a prospective observational study of
1000 consecutive patients with ST-segment elevation
myocardial infarction, who were treated with primary
percutaneous coronary intervention from December 2010 to
May 2014 at Sri Venkateswara Institute of Medical Sciences,
Tirupati, India. Patient characteristics, procedural details, inhospital
and 3-month adverse events were assessed.
Results. The mean (SD) age of our patients was 54.5
(11.3) years. Among the study population, 82.9% were
men, 32.8% had diabetes mellitus, and 36.3% had
hypertension. Only 18.2% of the patients came to hospital in
an ambulance, and 6% were in cardiogenic shock. Most
frequently, the left anterior descending artery was the infarctrelated
artery (57.9%). The mean (SD) time from onset of
symptoms to arrival at hospital was 369.6 (204.6) minutes
and the mean door-to-balloon time was 58.6 (17.1) minutes.
The in-hospital adverse event rate was 5.7% (mortality 3.6%,
non-fatal reinfarction 0.9%, stroke 0.3%, major bleeding
0.9%). Patients without cardiogenic shock had an in-hospital
survival rate of 99.1%. During 3 months of follow-up, 0.9%
of patients died and 0.8% had non-fatal reinfarction. The
3-month survival rate was 95.5%.
Conclusion. Primary percutaneous coronary intervention
is feasible in India with an acceptable door-to-balloon time and
low rates of adverse events despite longer time to presentation.
Natl Med J India 2015;28:276–9
Description
Keywords
Citation
Rajasekhar D., Vanajakshamma V., Vamsidhar A., Boochi Babu M., Latheef K. Experience of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction at a referral healthcare centre in India. National Medical Journal of India. 2015 Nov-Dec; 28(6):276-289.