In-hospital Outcomes of Primary Percutaneous Coronary Intervention in Patients Presenting with acute ST Elevation Myocardial Infarction in a Tertiary Care Hospital in Karachi

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.