Primary angioplasty in a high-volume tertiary center in Turkey: in-hospital clinical outcomes of 1625 patients [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(4): 300-307 | DOI: 10.5543/tkda.2011.01231

Primary angioplasty in a high-volume tertiary center in Turkey: in-hospital clinical outcomes of 1625 patients

Cevat Kırma1, Vecih Oduncu1, Ali Cevat Tanalp2, Ayhan Erkol1, Cihan Dündar1, Dicle Sırma1, Kürşat Tigen1, Selçuk Pala1, Akın İzgi1, Muhsin Türkmen1, Nihal Özdemir1, Hasan Sunar3
1Department of Cardiology, Kartal Kosuyolu Heart And Research Hospital, Istanbul, Turkey
2Department of Cardiology, Medicana International Hospital, Ankara, Turkey
3Department of Cardiovascular Surgery, Kartal Kosuyolu Heart And Research Hospital, Istanbul, Turkey


OBJECTIVES
We evaluated in-hospital results of primary percutaneous coronary intervention (PCI) in a high-volume tertiary center.

STUDY DESIGN
We retrospectively evaluated 1625 patients (1323 males, 302 females; mean age 56.0±11.6 years) who underwent primary PCI for acute ST-elevation myocardial infarction between January 2006 and April 2008. All coronary angiography procedures were performed using the femoral artery route. In-hospital clinical and angiographic results were recorded.

RESULTS
On admission, 23% of the patients had diabetes mellitus, 49.6% had anterior myocardial infarction, and 4.9% had cardiogenic shock. The mean duration of pain was 171.2±121.2 minutes, and the mean door-to-balloon time was 31.6±7.2 minutes. Infarct-related artery was the left anterior descending artery in 49.7%, multivessel disease was present in 40.9%, TIMI 2/3 flow was present in 23.6%, and high-grade thrombus was observed in 66.8%. Primary PCI involved balloon dilatation (5.7%) and stent implantation (94.3%). The incidence of angiographic no-reflow was 11.9%. The mean hospital stay was 5.2±3.3 days. All-cause mortality occurred in 71 patients (4.4%). Other in-hospital events were reinfarction (1.4%), target vessel revascularization (1.9%), hemorrhagic/ischemic stroke (0.6%), stent thrombosis (1.2%), major bleeding (3.8%), blood transfusion (4.8%), heart failure (10.5%), atrial fibrillation (4%), and ventricular tachycardia (3.9%).

CONCLUSION
Primary PCI is an effective method in achieving complete revascularization of the infarct-related artery. Successful in-hospital results not only depend on the experience and equipment of the center, but also on how rapidly reperfusion is achieved.

Keywords: Angioplasty, balloon, coronary, hospital mortality; myocardial infarction/therapy/mortality; treatment outcome.

How to cite this article
Cevat Kırma, Vecih Oduncu, Ali Cevat Tanalp, Ayhan Erkol, Cihan Dündar, Dicle Sırma, Kürşat Tigen, Selçuk Pala, Akın İzgi, Muhsin Türkmen, Nihal Özdemir, Hasan Sunar. Primary angioplasty in a high-volume tertiary center in Turkey: in-hospital clinical outcomes of 1625 patients. Turk Kardiyol Dern Ars. 2011; 39(4): 300-307

Corresponding Author: Vecih Oduncu, Türkiye
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