Author/Authors :
Khosravi، Ali Reza نويسنده Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Tehran, IR Iran , , Hoseinabadi، Mohamadhosein نويسنده Interventional Cardiology, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran , , Pourmoghaddas، Masoud نويسنده MD, Professor of Interventional Cardiology, Chamran Heart Hospital, Isfahan University of Medical Sciences, Isfahan , , Shirani، Shahin نويسنده Associate Professor, Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran , , Paydari، Navid نويسنده , , Sadeghi، Mahmoud نويسنده Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; , , Kanani، Soheila نويسنده Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran , , Jozan، Mahnaz نويسنده Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran , , KHOSRAVI، ELHAM نويسنده ,
Abstract :
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is considered as a choice of
treatment in ST-elevation myocardial infarction (STEMI). PPCI has been performed in the
Isfahan Province for several years. This study was performed to describe the situation, and
determine in-hospital and early (30 days) clinical outcomes of the patients in order to provide
sufficient evidence to evaluate and modify this treatment modality if necessary.
METHODS: All patients, who underwent PPCI for STEMI from July to December 2011 at
Chamran and Saadi Hospitals (PPCI centers in the Isfahan Province), were included in this case
series study. Premedication, angioplasty procedure, and post-procedural treatment were
performed using standard protocols or techniques. All discharged patients were followed for 30
days by phone. Endpoints consisted of clinical success rate, and in-hospital and 30 day major
adverse cardiac events (MACEs) (death, reinfarction, stroke, and target vessel
revascularization).
RESULTS: 93 patients (83 (89.2%) at Chamran Hospital and 10 (10.8%) patients at Saadi
Hospital) had PPCI. Mean Age of the patients was 59.60 ± 11.10 and M/F ratio was 3.89. From
the 181 involved vessels (involved vessels/patient ratio = 1.97 ± 0.70), the treatment of 105
lesions (lesions/patient ratio = 1.13 ± 0.368) was attempted. The clinical success rate was 72%.
Pain-to-door and door-to-balloon times were, respectively, 255.1 ± 221.4 and 148.9 ± 168.5 min.
The reason for failure was impaired flow (n = 17 (18.3%)), failure to cross with a guidewire
(n = 2 (2.2%)), suboptimal angiographic results (n = 2 (2.2%)), and death in one patient. The inhospital
and 30 days MACE rates were, respectively, 8.6% and 3.2%.
CONCLUSION: Low success rate in our series could be due to prolonged pain-to-door and doorto-
balloon times and lack of an established, definite protocol to regularly perform PPCI in a
timely fashion. We should resolve these problems and improve our techniques in order to
prevent and treat slow/no-reflow phenomenon.
