INTRODUCTION: Current evidence support primary percutaneous coronary intervention (PPCI) in experienced centre as the treatment for acute ST-elevation myocardial infarction (STEMI). Foothills Interventional Cardiology Service receives patients in the Calgary Health Region (CHR) for PPCI 24 hrs/day since the early 1990’s. More than 95% of patients presenting within 12 hours of pain onset from 3 emergency departments are referred for PPCI.

METHOD: As part of the cardiovascular Quality Improvement and Health Information initiative, a prospective registry was established in January 2002 to assess the process-of-care indicators and clinical outcomes of these patients.

RESULT: Between January 2002 to December 2003, 529 patients received PPCI for acute STEMI from the CHR. Baseline and clinical characteristics include: male gender of 72.7%, mean age of 61.5±14.4 yrs, previous myocardial infarction of 13.9%, anterior or LBBB of 25%, cardiogenic shock of 8.1%, and mean TIMI risk score of 2.98±2.13. Of which, 54.6% were transferred from non-interventional centres and 63.5% presented during off-hours and weekends. IIbIIIa inhibitor use was 77.4%. Median door-to-balloon time was 101 min with interquartile range (IQR) of 82 and 136 min. Detailed clinical outcomes are shown below.

CONCLUSION: Although, clinical outcomes in our STEMI database are comparable to large registries and clinical trials, overall door-to-balloon time and length of stay is less than ideal. This registry provides a snapshot of characteristics and outcomes of patients with PPCI from which results of further quality-of-care improvements can be compared.

DNC

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