Primary angioplasty in Northern Galicia: care changes and results following implementation of the PROGALIAM protocol.
OBJECTIVE
To analyze changes in healthcare delivery and results for primary angioplasty at Centro Hospitalario Universitario A Coruña following implementation of the PROGALIAM protocol.


METHODS
Observational registry of 1434 patients referred for primary angioplasty between 2003 and 2007. Results under PROGALIAM (May 2005 - December 2007; n=963) were compared with those from the preceding period (January 2003 - April 2005; n=388).


RESULTS
After implementing PROGALIAM, there were increases in the number of primary angioplasty procedures (preceding period, 14.4 cases/month; PROGALIAM, 32.2 cases/month), mean patient age (preceding period, 61.3 (11.9) years; PROGALIAM, 64.2 (11.7) years; P<.001), and the percentage of patients referred from peripheral hospitals and treated after normal working hours. Overall median first medical contact-to-balloon time increased (previous period, 106 min; PROGALIAM, 113 min; P=.02), but decreased significantly among patients referred from noninterventional centers (previous period, 171 min; PROGALIAM, 146 min; P<.001). Percentage of cases with an first medical contact-to-balloon time <120 min remained unchanged among interventional-center patients (preceding period, 69%; PROGALIAM, 71%; P=.56) and increased among patients at noninterventional centers, although it remained low in this subgroup (preceding period, 17%; PROGALIAM, 30%; P=.04). Thirty-day mortality (preceding period, 5.2%; PROGALIAM, 6.2%; P=.85) and 1-year mortality (preceding period, 9.5%; PROGALIAM, 10.2%; P=.96) remained unchanged.


CONCLUSIONS
Implementation of PROGALIAM allowed us to increase the percentage of patients receiving primary angioplasty without jeopardizing the clinical results of this treatment.
Servicio de Cardiología, Hospital Universitario A Coruña, A Coruña, España. blargesbueno@hotmail.com
Eduardo
E
Barge-Caballero
José Manuel
JM
Vázquez-Rodríguez
Rodrigo
R
Estévez-Loureiro
Ramón
R
Calviño-Santos
Jorge
J
Salgado-Fernández
Guillermo
G
Aldama-López
Pablo
P
Piñón-Esteban
Xacobe
X
Flores-Ríos
Rosa
R
Campo-Pérez
José Ángel
JÁ
Rodríguez-Fernández
José Antonio
JA
Lombán-Villanueva
Alejandro
A
Mesías-Prego
José Manuel
JM
Gutiérrez-Cortés
Carlos
C
González-Juanatey
Carlos
C
Portela
Antonio
A
Iglesias-Vázquez
Jacobo
J
Varela-Portas Mariño
Nicolás
N
Vázquez-González
Alfonso
A
Castro-Beiras
D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality / Q000706:statistics & numerical data*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003695:Delivery of Health Care; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D010360:Patient Transfer; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab