In-hospital Outcomes of Primary Percutaneous Coronary Intervention in Patients Presenting with acute ST Elevation Myocardial Infarction in a Tertiary Care Hospital in Karachi
Arshad Ali Shah
Dow University of Health Sciences Karachi Pakistan, Civil Hospital Karachi, Karachi, Pakistan.
Syed Dilbahar Ali Shah
Dow University of Health Sciences Karachi Pakistan, Civil Hospital Karachi, Karachi, Pakistan.
Amara Zafar
The Aga Khan University Hospital, Karachi, Pakistan.
Ghulam Abbas Shaikh
Dow University of Health Sciences Karachi Pakistan, Civil Hospital Karachi, Karachi, Pakistan.
Muhammad Aslam
National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Suresh Kumar
National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Abdul Majid
Dr. Ruth K. M. Pfau, Civil Hospital Karachi, Pakistan.
Maheen Khan
Dr. Ruth K. M. Pfau, Civil Hospital Karachi, Pakistan.
Hareem Syed
Dr. Ruth K. M. Pfau, Civil Hospital Karachi, Pakistan.
Muhammad Sami Khan
Dow University of Health Sciences Karachi Pakistan, Civil Hospital Karachi, Karachi, Pakistan.
Mohammad Nawaz Lashari
Dow University of Health Sciences Karachi Pakistan, Civil Hospital Karachi, Karachi, Pakistan.
Dileep Kumar *
Dow University of Health Sciences Karachi Pakistan, Civil Hospital Karachi, Karachi, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Background: Although primary percutaneous coronary intervention (PPCI) is now frequently performed in Pakistan, there is little data available regarding its outcomes in tertiary care hospitals of Pakistan. This study was designed to determine the outcomes, and assess the factors influencing these outcomes of PPCI.
Methods: It is a retrospective study conducted on the data of patients who presented to the department of Cardiology, Dr. Ruth K.M. Pfau Civil Hospital Karachi from October 2017 to March 2019 with acute ST-elevation myocardial infarction (STEMI) and underwent PPCI. A total of 115 patients were included in this study.
Results: Out of the 115 patients, 111 had a successful PPCI. The total mortality was 2.6% (3 deaths). One of the patients was reported to have a stent thrombosis. No emergency coronary artery by-pass graft (CABG) was performed and none of the patients had a stroke or any major bleeding. An accelerated idioventricular rhythm (AIVR) was noted in 23 (20%) of the patients. Pre-procedure 87% of the patients had thrombolysis in myocardial infarction (TIMI) grade 0 and only 11.3% were having TIMI flow grade 1. Post procedure a vast majority of the patients (97%) achieved TIMI flow grade 3.
Conclusions: Our study reports a very high success rate of PPCI which is consistent with the data reported from the Western countries. A major limitation of our study was the relatively small sample size. A larger sample size would have better predicted outcomes considering this is one of the few such studies in this region. Further studies with larger sample size and long-term follow up outcomes are recommended.
Keywords: Primary percutaneous coronary intervention, ST-elevation myocardial infarction, thrombolysis in myocardial infarction, killip class, coronary artery disease