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Open Access Barriers to the Implementation of Primary PCI in the Management of STEMI in Egypt

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This article is Open Access under the terms of the Creative Commons CC BY licence.

Introduction: Evidence-based guidelines recommend primary percutaneous coronary intervention (PPCI) be the mainstay reperfusion strategy for the treatment of ST-segment elevation myocardial infarction (STEMI) if it is performed in the proper time window. However, the Egyptian health care system is still struggling to provide such an important service. The aim of the present study, through a quantitative questionnaire, is to explore the current practice of STEMI management in Egypt, and to identify the barriers, opportunities, and potential areas for improvement.

Methods and Results: The questionnaire was conducted in Egypt via face-to-face qualitative in-depth interviews with cardiologists from 14 PPCI-capable hospitals and 26 non-PPCI-capable hospitals. Participants were selected in view of their experience and knowledge. The study identified potential barriers to the implementation of PPCI among STEMI patients in Egypt. These barriers included the prehospital patient delay and emergency medical service delay, delay in the emergency department and delay in patient transfer to the CCU, unavailable equipment, catheterization laboratory activation delay, lack of trained interventional cardiologists, lack of regional STEMI networks and hospital policies, and insufficient ICU beds.

Conclusion: Limited resources and health care system inadequacies have led to potential barriers that prevent suboptimal implementation of PPCI in Egypt. Efforts from all health care providers should be directed to overcome these identified barriers.

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Keywords: Egypt; ST-segment elevation myocardial infarction; barriers; primary percutaneous coronary intervention

Document Type: Research Article

Affiliations: 1: Faculty of Medicine, Ain Shams University, Cairo, Egypt 2: Faculty of Medicine, Fayoum University, Fayoum, Egypt 3: Faculty of Pharmacy, Ain Shams University, Cairo, Egypt

Publication date: December 1, 2021

This article was made available online on August 3, 2021 as a Fast Track article with title: "Barriers to the Implementation of Primary PCI in the Management of STEMI in Egypt".

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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