Outcomes of primary percutaneous coronary intervention in acute myocardial infarction at Tehran Heart Center.

OBJECTIVE To describe our experience of primary angioplasty in ST-segment elevation myocardial infarction. SUBJECTS AND METHODS During a period of 2 years (April 2003 to May 2005), 83 high-risk patients presenting with acute ST-segment elevation myocardial infarction underwent primary angioplasty subject to availability of balloon dilation within 90 min of admission. In total, 73 stents were implanted; 69 were bare metal stents, while the remaining 4 were paclitaxel-eluting stents. Of the 83 patients, 8 presented with cardiogenic shock. Follow-up was for a period of 9 months. All angiographic, in-hospital and clinical outcomes were recorded on a database. RESULTS The procedure was successful in 79 of the 83 patients (95%) and unsuccessful in 4 (5%). Of these 4 patients, 3 died and 1 was treated medically. In 65 patients with zero perfusion, angioplasty was successful in 61 (93.8%), while it was completely successful (100%) in the remaining 18 patients with thrombolysis in myocardial infarction grade 3 perfusion. Vessel patency was achieved in 95% with thrombolysis in myocardial infarction grade 3 flow present in 93%. A total of 7 (8.5%) patients died while in the hospital. Of the 8 with initial cardiogenic shock on presentation, 4 (50%) died in the hospital and of the remaining 4, 1 was lost at 9-month follow-up. In-hospital reocclusion and reinfarction did not occur in any patient. CONCLUSION The results suggest that primary angioplasty is logistically feasible in our center with good clinical outcomes.