title: Primary Percutaneous Coronary Intervention (PPCI) in acute myocardial infarction complicated with cardiogenic shock in a newly emerging cardiac center in Nepal.
abstract: BACKGROUND
  Acute myocardial infarction (AMI) is complicated by cardiogenic shock in 7~10% of patients. Mortality rate is exceedingly high and reaches 70-80% in those treated conservatively. Large thrombolytic trials demonstrate 60% mortality with most effective thrombolytic agent.
  
  
  METHODS
  In between September 2005 to August 2008 total PCI in Shahid Gangalal National Heart Center (SGNHC) in Nepal was 452. Among them primary PCI (PPCI) in AMI with cardiogenic shock was done in only 16 patients (3.5%).
  
  
  RESULTS
  This study showed in-hospital mortality of 50% (n = 8). Of 50% (n = 8) alive patients with cardiogenic shock who underwent PPCI, 6 patients are in routine follow-up over 12 months and 2 were doing well in subsequent 6 months but not in follow up after that.
  
  
  CONCLUSIONS
  Primary PCI in AMI complicated by cardiogenic shock has lower mortality and improved outcome. High cost, high in-hospital mortality and lack of trained personnel are major limitations.
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
authors.forename: Arun
authors.initials: A
authors.lastname: Maskey
authors.forename: Shyam Raj
authors.initials: SR
authors.lastname: Regmi
authors.forename: Laxman
authors.initials: L
authors.lastname: Dubey
authors.forename: Yadab
authors.initials: Y
authors.lastname: Bhatt
authors.forename: Rabi
authors.initials: R
authors.lastname: Malla
authors.forename: Yuba Raj
authors.initials: YR
authors.lastname: Limbu
authors.forename: Deewakar
authors.initials: D
authors.lastname: Sharma
authors.forename: Man
authors.initials: M
authors.lastname: Bahadur