Clinical End Result in Indian Patients Undergoing Primary Percutaneous Coronary Intervention in Institution without Onsite Surgical Facilities

Abstract

BACKGROUND Primary percutaneous coronary intervention is one of the treatment options for STelevation myocardial infarction and is relatively safer and superior to thrombolytic therapy. The decrease in time to reperfusion leads to decreased infarct size and hence incidence of major adverse cardiac events (MACE). This knowledge has led to the concept of off-site percutaneous coronary intervention centres (without surgical backup). However, performing primary percutaneous coronary intervention at centres without surgical backup has been controversial. Controversy arises regarding the safety and efficacy of primary percutaneous coronary intervention in centres without onsite surgical backup. No such studies have been available among Indian population regarding the outcome in patients undergoing primary coronary intervention in centres without surgical backup. Thus, our study focusses on one year clinical outcomes in Indian patients undergoing primary percutaneous coronary intervention without on-site surgical backup.1-8 METHODS It was done as an observational, single centre, retrospective study. It included 139 patients, who were diagnosed with ST elevation myocardial infarction (STEMI) who underwent primary PCI from February 2019 to June 2020 at Rajah Hospital, Thrissur, Kerala, India. The primary endpoint of the study was occurrence of major adverse cardiac events, a sum of target vessel revascularisation (TLR), cardiac death, and myocardial infarction at one year after procedure. RESULTS 83.45 % were males. 30.21% were hypertensives and 48.92 % were diabetics. There were four cardiac deaths at 30-day follow-up and 4 (2.87 %) events of TLR at one-year follow-up. And additionally, the mean age of population was 56.05 years. CONCLUSIONS Considering these results, it can be concluded that mainly in the developing countries like India; primary PCI can be performed safely at PCI centres which lack the facility of on-site surgical backup. KEY WORDS ST-Elevation Myocardial Infarction, Percutaneous Coronary Intervention, Coronary Artery Disease.