Clinical outcomes of patients with acute myocardial infarction treated by converse transport PCI / 中国综合临床

ABSTRACT

Objective To evaluate the safety,feasibility and efficacy of emergency percutaneous coronary intervention(PCI)on the spot in the patients with acute myocardial infarction(AMI)in country hospitals by interventional cardiologists from higher-level hospitals(converse transport).Methods A total of 81 AMI patients received emergency PCI on the spot by interventional cardiologists from other higher-level hospitals (transported doctors)from Mar 2004 to Sep 2008 in our hospital.The mean age of patients was 68.6 ± 3.6 years (36.0-83.0 years).Forty-six patients were male and 35 were female.There were 56 cases with anterior myocardial infarction and 25 with inferior myocardial infarction(including 11 cases combined with right ventricular infarction).The average time from symptom onset to admission was 6.2 ± 1.8 hours(2.0-12.0hours).Results Three cases were transported to higher-level hospitals for CABG because of severe conditions.The other 78 cases received emergency PCI on the spot,among whom 66 cases received primary PCI.Another 12 cases received rescue PCI.Eight one stents were implanted in total into the infarcted arteries.One operation was failed because the balloon could not go through the lesion.The success.rate was 98.7％.Four patients occurred peri-operative cardiac adverse events and 2 cases died.Four cases died during the 32-86 months follow-up,of whom I was cardiac death and 3 was non-cardiac deaths.No fatal cardiovascular events occurred in the remained cases.Conclusion Emergency PCI on the spot by interventional cardiologists from other cities(converse transport PCI)in AMI is safe,feasible and effective.But it needs to be confirmed in a large-scale study in the future.