[A year"s experience with primary percutaneous intervention as the standard treatment of patients with ST-elevation infarction in the County of North Jutland].
BACKGROUND
Primary percutaneous intervention (PCI) became the standard treatment of patients with ST-elevation infarction in the hospitals in the County of North Jutland in May 2002, according to a protocol that was slightly modified from that used in the DANAMI-2 study: A cumulated ST elevation of 2 mm was required, versus 4 mm in the DANAMI-2 study; the ECG analyses were performed centrally after transmission of the ECGs to a mobile fax at the PCI centre; and in selected cases the intervention technique was supplemented with thrombectomy. The purpose of this study was to assess whether primary PCI in clinical practice with these modifications gave satisfactory results compared to the invasive arm of the DANAMI-2 study.


METHODS
The study comprised all patients who underwent acute coronary angiography due to ST-elevation infarction in the Department of Cardiology, Aalborg Hospital, from 1 May 2002 to 30 April 2003. The patients were admitted to the nearest hospital and transferred to the PCI centre for acute intervention.


RESULTS
The study comprised 297 patients. In transported as well as non-transported patients, the median times from onset of symptoms to invasive treatment in the Aalborg material were a few minutes shorter than in the DANAMI-2 study. PCI treatment was performed in 266 patients (90%), of whom 247 (93%) had a stent implanted, as had been done in the DANAMI-2 study. TIMI III flow was achieved in 94% of the cases versus 89% in the DANAMI-2 study. In the patients who underwent PCI treatment, the mortality rates after 30 days were 4.0% and 5.4%, respectively.


CONCLUSIONS
This study showed that it was possible to implement primary PCI in clinical practice with results better than those attained by fibrinolysis. Consequently, primary PCI should continue to be the preferred reperfusion treatment of ST-elevation infarction.
Rasmussen
Klaus
K
Aalborg Sygehus, Kardiologisk Afdeling, Aalborg. kr@aas.nja.dk
Ravkilde
Jan L
JL
Nielsen
Thomas Vesterlund
TV
Villadsen
Anton Boel
AB
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003718:Denmark / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents