Outcomes of Primary Percutaneous Coronary Intervention at Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Journal Title: Journal of Advances in Internal Medicine - Year 2013, Vol 2, Issue 1
Abstract
Background and Aims- Reperfusion therapy is indicated for patient with acute ST Elevation Myocardial Infarction. Several randomized trials and meta-analyses have shown that Primary Percutaneous Coronary Intervention is better than thrombolysis. Our aim was to determine the outcomes of Primary Percutaneous Coronary Intervention in Shahid Gangalal National Heart Centre, Nepal. Methods- Medical records of 212 Primary Percutaneous Coronary Intervention from March 2007 to March 2012 were retrospectively reviewed. The primary end point was in-hospital mortality and secondary end points were 30 day mortality and long term mortality. Results- In the patients presenting to emergency with acute ST elevation myocardial infarction, inferior wall Myocardial Infarction 64 (30%) was the most common. Single vessel disease 168 (79%) predominated in emergency coronary angiogram. In majority of the patients Right Coronary Artery 103 (48.7%) was the culprit vessel. Cardiogenic shock was present in 28 (13.2%) patients. There were 11 deaths (39.2%) in cardiogenic shock group where as only 5 deaths (2.7%) among 184 non cardiogenic shock patients, resulting in in hospital mortality rate of 7.5%. Among the 196 patients who were successfully discharged from the hospital, 21 patients lost to follow up. There was one death reported within a month, non within three months and four within a year post discharge from the hospital. Conclusions- The result of this study is comparable to the findings elsewhere in the world. Primary Percutaneous Coronary Intervention should be the treatment of choice in treating acute myocardial infarction where the facilities and the expertise are available.
Authors and Affiliations
Chandra Mani Adhikari*| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Yadav Deo Bhatta| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Rabi Malla| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Arun Maskey| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Rajib Rajbhandari| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Shyam Raj Regmi| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Ranjit Sharma| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Subodh Kansakar| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Himanshu Prasad Nepal| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Nagma Shrestha| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Rabindra Pandey| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Dipankar Prajapati| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Roshan Raut| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Murari Dhungana| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Dharma Nath Yadav| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Binay kumar Rauniyar| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal., Man Bahadur KC| Department of Cardiology, Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal.
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