title: Outcome of primary PCI - an Indian tertiary care center experience.
abstract: OBJECTIVE
  To assess the feasibility and outcomes of primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) in Indian Scenario.
  
  
  METHODS
  Between January 2005 and December 2012, consecutive STEMI patients who underwent PPCI within 12 h of onset of chest pain were prospectively enrolled in a PPCI registry. Patient demographics, risk factors, procedural characteristics, time variables and in-hospital and 30 day major adverse cardiovascular events (MACE) [death, reinfarction, bleeding, urgent coronary artery bypass surgery (CABG) and stroke] were assessed.
  
  
  RESULTS
  A total of 672 patients underwent PPCI during this period. The mean age was 52 ± 13.4 years and 583 (86.7%) were males, 275 (40.9%) were hypertensives and 336 (50%) were diabetics. Thirty one (4.6%) patients had cardiogenic shock (CS). Anterior myocardial infarction was diagnosed in 398 (59.2%) patients. The median chest pain onset to hospital arrival time, door-to-balloon time and total ischemic times were 200 (10-720), 65 (20-300), and 275 (55-785) minutes respectively. In-hospital adverse events occurred in 54 (8.0%) patients [death 28 (4.2%), reinfarction 8 (1.2%), major bleeding 9 (1.3%), urgent CABG 4 (0.6%) and stroke 1 (0.14%)]. Nineteen patients with CS died (mortality rate - (61.3%)). At the end of 30 days, 64 (9.5%) patients had MACE [death 35 (5.2%), reinfarction 10 (2.1%), major bleeding 10 (1.5%), urgent CABG 4 (0.6%) and stroke 1 (0.1%)].
  
  
  CONCLUSIONS
  Our study has shown that PPCI is feasible with good outcomes in Indian scenario. Even though the recommended door-to-balloon time can be achieved, the total ischemic time remained long. CS in the setting of STEMI was associated with poor outcomes.
authors.affiliation: Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Vijayakumar
authors.initials: V
authors.lastname: Subban
authors.affiliation: Physician Assistant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Anitha
authors.initials: A
authors.lastname: Lakshmanan
authors.affiliation: Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Suma M
authors.initials: SM
authors.lastname: Victor
authors.affiliation: Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Pakshirajan
authors.affiliation: Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Kalaichelvan
authors.initials: K
authors.lastname: Udayakumaran
authors.affiliation: Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Gnanaraj
authors.affiliation: Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Ramkumar
authors.initials: R
authors.lastname: Solirajaram
authors.affiliation: Senior Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Jaishankar
authors.initials: J
authors.lastname: Krishnamoorthy
authors.affiliation: Senior Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Ezhilan
authors.initials: E
authors.lastname: Janakiraman
authors.affiliation: Senior Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Ulhas M
authors.initials: UM
authors.lastname: Pandurangi
authors.affiliation: Senior Consultant, Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Latchumanadhas
authors.initials: L
authors.lastname: Kalidoss
authors.affiliation: Director, Department of Cardiology, Institute of Cardiovascular Diseases, Madras Medical Mission, 4A, JJ Nagar, Mogappair, Chennai 600 037, India. Electronic address: icvddoctors@mmm.org.in.
authors.forename: Ajit Sankardas
authors.initials: AS
authors.lastname: Mullasari
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000401:mortality; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D015996:Survival Rate; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: Major adverse cardiovascular events; Primary percutaneous coronary intervention; ST-segment elevation myocardial infarction