Outcome of early coronary intervention for acute ST elevation myocardial infarction in a tertiary care cardiac centre in Sri Lanka

Ceylon Med J. 2016 Mar;61(1):26-31. doi: 10.4038/cmj.v61i1.8258.

Abstract

Objectives: To describe the outcomes of early percutaneous coronary intervention (PCI) for the treatment of acute ST elevation myocardial infarction (STEMI) in a tertiary care cardiac centre in Colombo, Sri Lanka.

Methods: Medical records of 139 consecutive patients presenting to Cardiology Unit 5, National Hospital of Sri Lanka from March 2013 to June 2014 with acute STEMI, and treated with early PCI as a mode of reperfusion were reviewed. These patients were then followed up for 6 months to determine survival, target-vessel revascularization, in-stent thrombosis and other major adverse cardiac events (MACE).

Results: Of 139 patients, 116 (83.5%) were male. Mean age was 52.3±SD11.1 years. Eighty eight (63.3%) patients underwent primary PCI and 51 (36.7%) underwent rescue PCI. There were six deaths (4.3%). One occurred on-table and three occurred after discharge. Four patients who died had cardiogenic shock. Mean door-to-balloon (DTB) time was 147 minutes for the primary PCI patients who were transferred from ETU. At six months, of 106 patients who attended follow up, two had been re-hospitalised for heart failure but none underwent coronary artery bypass grafting (CABG).

Conclusions: This report from the national tertiary care cardiology referral centre in Sri Lanka, found that the study population was relatively younger, similar to other Asian countries. There was high rate of initial success (98.6%) and good short-term survival (95.7%), particularly in the subset presenting without cardiogenic shock (98.4%) despite the long DTB time. Loss to follow up at 6 months in this centre was 23.7% (33 patients).

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission
  • Percutaneous Coronary Intervention*
  • ST Elevation Myocardial Infarction / mortality
  • ST Elevation Myocardial Infarction / surgery*
  • Sri Lanka
  • Survival Rate
  • Tertiary Care Centers
  • Time Factors
  • Time-to-Treatment
  • Treatment Outcome