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Current Research: Cardiology

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In hospital outcomes of primary percutaneous intervention in patients presenting with acute myocardial infarction in Saudi Arabia – A single center study

Author(s): Saad Al Bugami*, Akram Niaz, Mosa Alabbadi, Amani Alsubaie, Abdullah Almalki, Jamilah Alrahimi, Nassir Mansour, Wail Alkashkari and Ahmed Krimly

OBJECTIVE: To study the presentation, response to treatment, complication and prognosis of patients with acute ST-Elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PPCI) at King Faisal Cardiac Center (KFCC) in the period from January 2015 till December 2016.

METHODS: Data of 77 patients with STEMI who were treated with primary PCI as a mode of reperfusion who presented to KFCC were collected retrospectively from January 2015 till December 2016. The primary end point was in hospital mortality.

RESULTS: 77 patients with STEMI received PPCI. These were predominantly male (86%, no=66). The mean age was 57.9 (SD ± 11.8). History of Diabetes was present in (64.7%, no=49), hypertension (49% no=38) dyslipidemia (51% no=39) and smoking (41.6%, no=32). Chest pain was the most common presenting symptoms (97%, no=75). Only 5 patients (6%) presented to emergency department within 1 hour from chest pain onset. While 7 (8%) of patients presented beyond 12 hours the majority of patients arrived within 6 hours 29 patients (38%) and 37 patients (48%) arrived after 6 hours but within 12 hours from pain onset. The median door to balloon time was 84 minutes (IQR: 63.5- 111.5 minutes). Door to balloon time of less than 90 minutes was achieved in (62%, no=46) while D2B time of more than 90 minutes but within 120 minutes was seen in (22 %,) while (16%) had D2B time of more than 120 minutes. The left anterior descending artery was the culprit in 37 patients (48%) Femoral artery access was used in 48 patients (62%).The success of delivering the stent was 97% (no =75). The Median length of hospital stay was 3 days (IQR: 2-4). The primary endpoint of inhospital death was 5.1%.

CONCLUSION: Our findings suggest favorable outcomes of STEMI patients treated with PPCI, matching the international data. D2B time remains below acceptable standers. Regardless of logistic limitations Primary PCI should be the preferred method of reperfusion. Strategies towards increasing patient’s access and improving D2B time should be adopted.


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