Document Detail


Current Reperfusion Strategies for ST-Elevation Myocardial Infarction in an Academic Medical Center in a Developing Country: Efficacy of Primary Percutaneous Coronary Intervention.
MedLine Citation:
PMID:  23411604     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: : To study the reperfusion strategies currently being used in the treatment of ST-elevation myocardial infarction (STEMI) at an academic medical center in a developing country and to analyze the door-to-balloon time (DBT) in those patients undergoing primary percutaneous coronary intervention (PCI).
METHODS: : The study included all patients presenting with STEMI to the emergency department at the American University of Beirut Medical Center between July 2008 and February 2010. Data were collected prospectively from the patients' medical records.
RESULTS: : The study population consisted of 100 consecutive patients. Compared with an earlier study from American University of Beirut Medical Center done in 2002-2005, there was a significant increase in the utilization of primary PCI for reperfusion (81% vs. 2.5%; P < 0.001). However, the median DBT was 110 minutes, with only 30% of patients achieving a DBT ≤90 minutes. The predictors of delayed DBT (>90 minutes) were culprit lesions in the circumflex artery (P = 0.007) and delayed time from electrocardiogram to arrival in the catheterization laboratory (P < 0.001).
CONCLUSIONS: : There was a significant increase in the utilization of primary PCI for reperfusion of STEMI in this academic medical center in a developing country. However, achieving a target DBT ≤90 minutes was suboptimal. Future studies are needed to analyze the logistic factors associated with delayed reperfusion to institute policies and systems that can enhance the efficacy of primary PCI as a reperfusion modality in these countries.
Authors:
Ali Rabah; Katia El-Sibai; Abeer Dakik; Salam Itani; Habib A Dakik
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical pathways in cardiology     Volume:  12     ISSN:  1535-2811     ISO Abbreviation:  Crit Pathw Cardiol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101165286     Medline TA:  Crit Pathw Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-7     Citation Subset:  IM    
Affiliation:
From the Department of Internal Medicine, American University of Beirut, Lebanon.
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