Primary coronary intervention for ST elevation myocardial infarction in a starting heart center in Indonesia: the first 100 patients
Abstract
Background: The benefits of Primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) have been demon-strated, but most studies were conducted in experienced centres in western world. Experience, logistics and patient characteristics may differ in other parts of the world, particularly in a starting center.Methods: Data on all consecutive STEMI patients treated with primary PCI in Cinere hospital, Jakarta, Indonesia were collected in a prospective database.
Results:,Between July 2006 and December 2008, a total of 100 patients with STEMI were treated by primary PCI. Mean age was 56.9 ±10.4 years (range 37-82), 88% was male. Mean time between onset of chest pain and admission was 369 ± 388 minutes. The mean time between admission and balloon inflation was 258 minutes. Before PCI, 50% of patients had TIMI 0 flow. After primary PCI 94% of patients had TIMI 2/3 flow. There were no deaths in the catheterisation room, and no emergency coronary bypass surgery was needed as a result of PCI complications. Mean left ventricular ejection fraction as measured by echocardiography after 1 day was 48 ± 12 %.
Conclusions: Outcome after primary PCI at a starting center is excellent in this series. Primary PCI was effective in restoration of TIMI flow, without complications. Time delay between symptom onset, admission and balloon inflation was long and all efforts should be encouraged to shorten this.
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References
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Wharton TP Jr, Grines LL, Turco MA, Johnston JD, Souther J, Lew DC,et al. Primary angioplasty in acute myocardial infarc-tion at hospitals with no surgery on-site (the PAMI-No SOS Study) versus transfer to surgical centers for primary angioplasty. J Am Coll Cardiol 2004;43:1943-50.
Wennberg DE, Lucas FL, Siewers AE, Kellett MA, Malenka DJ. Outcomes of percutaneous coronary interventions performed at centers without and with onsite coronary artery bypass graft surgery. JAMA 2004;292:1961-8.
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McGrath PD, Wennberg DE, Dickens JD Jr, et al. Relation between operator and hospital volume and outcomes following percutaneous coronary interventions in the era of the coronary stent. JAMA. 2000;284:3139-44.
Moscucci M, Share D, Smith D, O’Donnell MJ, et al. Re-lationship between operator volume and adverse outcome in contemporary percutaneous coronary intervention practice: an analysis of a quality-controlled multicenter percutaneous coronary intervention clinical database. J Am Coll Cardiol. 2005;46:625-32.
Politi A, Galli M, Zerboni S, Michi R, De Marco F, Llambro M, Ferrari G. Operator volume and outcomes of primary an-gioplasty for acute myocardial infarction in a single high-volume centre. J Cardiovasc Med (Hagerstown). 2006;10:761-7.
Smith PM, Burgess E. Smoking cessation initiated during hos-pital stay for patients with coronary artery disease: a randomized controlled trial. CMAJ. 2009 Jun 23;180(13):1297-303.
Stone GW. Angioplasty strategies in ST-segment–elevation myocardial infarction. Part I: primary percutaneous coronary intervention. Circulation 2008;118:538-51.
Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD, Buller CE, Jacobs AK, Slater JN, Col J, McKinlay SM, LeJemtel TH. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Engl J Med. 1999;341:625– 34.
Zahn R, Schiele R, Schneider S, Gitt AK, Wienbergen H, Seidl K, Voigtlander T, Gottwik M, Berg G, Altmann E, Rosahl W, Senges J. Primary angioplasty versus intravenous thrombolysis in acute myocardial infarction: can we define subgroups of patients benefiting most from primary angioplasty? J Am Coll Cardiol 2001;37:1827–35.
Gupta M,Singh N, Verma S. South Asian and Cardiovascu-lar Risk, What Clinicians Should Know. Circulation. 2006; 113:e924-9.
Santoso T. Prevention of cardiovascular disease in diabetes mellitus: by stressing the CARDS study. Acta Med Indones. 2006;38:97-102.
Martiniuk AL, Lee CM, Lawes CM, Ueshima H, Suh I, Lam TH, Gu D, Feigin V, Jamrozik K, Ohkubo T, Woodward M; Asia-Pacific Cohort Studies Collaboration. Hypertension: its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region. J Hyper-tens. 2007;1:73-9.
Martiniuk AL, Lee CM, Lam TH, Huxley R, Suh I, Jamrozik K, Gu DF, Woodward M; Asia Pacific Cohort Studies Collabora-tion. The fraction of ischaemic heart disease and stroke attribut-able to smoking in the WHO Western Pacific and South-East Asian regions. Tob Control 2006;15:181-8.
Woodward M, Lam TH, Barzi F, Patel A, Gu D, Rodgers A, Suh I; Asia Pacific Cohort Studies Collaboration. Smoking, quitting, and the risk of cardiovascular disease among women and men in the Asia-Pacific region. Int J Epidemiol. 2005;34:1036-45.
Wharton TP Jr, Grines LL, Turco MA, Johnston JD, Souther J, Lew DC,et al. Primary angioplasty in acute myocardial infarc-tion at hospitals with no surgery on-site (the PAMI-No SOS Study) versus transfer to surgical centers for primary angioplasty. J Am Coll Cardiol 2004;43:1943-50.
Wennberg DE, Lucas FL, Siewers AE, Kellett MA, Malenka DJ. Outcomes of percutaneous coronary interventions performed at centers without and with onsite coronary artery bypass graft surgery. JAMA 2004;292:1961-8.
Ong SH, LIM, VYT, Chang BC, et al. Three-Year Experience of Primary Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial Infarction in a Hospital without On-site Cardiac Surgery. Ann Acad Med Singapore 2009;38:1085-9.
McGrath PD, Wennberg DE, Dickens JD Jr, et al. Relation between operator and hospital volume and outcomes following percutaneous coronary interventions in the era of the coronary stent. JAMA. 2000;284:3139-44.
Moscucci M, Share D, Smith D, O’Donnell MJ, et al. Re-lationship between operator volume and adverse outcome in contemporary percutaneous coronary intervention practice: an analysis of a quality-controlled multicenter percutaneous coronary intervention clinical database. J Am Coll Cardiol. 2005;46:625-32.
Politi A, Galli M, Zerboni S, Michi R, De Marco F, Llambro M, Ferrari G. Operator volume and outcomes of primary an-gioplasty for acute myocardial infarction in a single high-volume centre. J Cardiovasc Med (Hagerstown). 2006;10:761-7.
Smith PM, Burgess E. Smoking cessation initiated during hos-pital stay for patients with coronary artery disease: a randomized controlled trial. CMAJ. 2009 Jun 23;180(13):1297-303.
Stone GW. Angioplasty strategies in ST-segment–elevation myocardial infarction. Part I: primary percutaneous coronary intervention. Circulation 2008;118:538-51.
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How to Cite
Juwana, Y., Ottervanger, J., Dambrink, J.-H., van’t Hof, A., de Boer, M.-J., Hoorntje, J., & Suryapranata, H. (1). Primary coronary intervention for ST elevation myocardial infarction in a starting heart center in Indonesia: the first 100 patients. Indonesian Journal of Cardiology, 32(2), 71-6. https://doi.org/10.30701/ijc.v32i2.102
Section
Clinical Research
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