Results of primary percutaneous coronary intervention in a consecutive group of patients with acute ST elevation myocardial infarction at a tertiary Australian centre

$48.00 plus tax (Refund Policy)

Download / Buy Article:


Abstract Background:

Multicentre randomized controlled trials (RCT) of primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) have consistently shown lower mortality compared with fibrinolysis, if carried out in a timely manner. Although primary PCI is now standard of care in many centres, it remains unknown whether results from RCT of selected patients are generalizable to a ‘real-world’ Australian setting. The primary goal of this study was to evaluate whether a strategy of routine invasive management for patients with STEMI can achieve 30-day and 12-month mortality rates comparable with multicentre RCT. Secondary goals were to determine 30-day mortality rates in prespecified high-risk subgroups, and symptom-onset- and door-to-balloon-inflation times. Methods:

A retrospective observational study of 189 consecutive patients treated with primary PCI for STEMI in a single Australian centre performing PCI for acute STEMI. Results:

All-cause mortality was 6.9% at 30 days, and 10.4% at 12 months. Mortality in patients presenting without cardiogenic shock was low (2.4% at 30 days; 5.0% at 12 months), whereas 12-month mortality in patients with shock was higher, particularly in the elderly (29.4% for patients <75 years; 85.7% for patients ≥75 years, P = 0.01). Symptom-onset-to-balloon-inflation time was ≤4 h in 56% of patients (median 231 min); however, a door-to-balloon time of <90 min was achieved in only 20% (median 133 min). Conclusion:

Mortality and symptom-onset-to-balloon-inflation times reported in RCT of primary PCI for STEMI are generalizable to ‘real-world’ Australian practice; however, further efforts to reduce door-to-balloon times are required.

Keywords: emergency treatment; mortality outcomes assessment; myocardial infarction; percutaneous transluminal angioplasty

Document Type: Research Article


Affiliations: 1: Department of Cardiology, Austin Health 2: Department of Cardiology, Royal Brompton Hospital, London, United Kingdom 3: Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia

Publication date: July 1, 2007

Related content



Share Content

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more