Asfar Raza, Nuri MMH, Muhammad A Karamat, Sohail Aziz, Khalid Raja, Azhar M Kyani, Waqar Ahmad, Farhan Tayyab, Imran Majeed.
Primary PTCA in acute Myocardial Infarction - Our experience at the Armed Forces Institute of Cardiology and National Institute of Heart Diseases Rawalpindi Pakistan.
Pak Heart J Jan ;35(1-4):2-6.

Background: Primary PTCA, has been shown to be superior to any thrombolytic therapy and offers higher reperfusion rates and better coronary flow grades. We therefore carried out a prospective study to see the safety, efficacy and clinical outcome of primary PTCA at our institute. Methods: Patients with less than 12 hours history of chest pain and ECG changes of acute Myocardial Infaretion (AMI) were recruited in this study from March 2001 onward. Patients in Killip III, and those in cardiogenic shock were excluded from the study. The infarct related artery was opened up and stented to restore normal flow. Patients were routinely prescribed aspirin, and ticlopidine or clopedogril. Platelet GP IIb/IIIa inhibitor (Abciximab or Tirofiban) was given to those patients with visible thrombus in coronary arteries. Procedure related complications and in-hospital major adverse cardiac events (MACE) were recorded for each patient. Results. Of 103 patients studied until June 2002, 95 patients had TIMI 0 flow and 8 had TIMI I flow in the infarct related artery (52 LAD, 29 RCA and 22 Cx). Average `door to balloon` time was 180 min. 101(98%) patients had successful PTCA and a single stent deployed in the infarct related artery. There was no mortality or major bleeding complications. Only four patients developed sizeable groin haematoma, which was manageable conservatively. Conclusions.. Our results show that primary PTCA is safe and effective with high primary success rate and no short-term MACE at our center. However we need to improve the logistics to reduce `door-to-balloon` time.

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