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Primary PCI for STEMI

Primary PCI vs Thrombolytic treatment for STEMI.
  • In case of STEMI, it has been established that primary PCI that can be accomplished within the time frame as indicated above is better than thrombolytic treatment.
Bangkok Heart Hospital Primary PCI for STEMI program
  • Acute Myocardial Infarction management program at Bangkok Heart Hospital has been certified by Joint Commission International 2008.
  • Direct admission result
Primary PCI for STEMI for direct admission patients at Bangkok Heart Hospital, 2012-2014
  • Consecutive cases that have the initial diagnosis at Bangkok Heart Hospital
  • During this period we have not used thrombolytic treatment as an initial reperfusion therapy
  • "Door to Balloon time", with cases exclusion per ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and Non-ST-Elevation Myocardial Infarction, as in the table below:
Number of case 33
Median door to balloon time 84 Minutes
Percentage of median door to balloon time <90 Minutes 60.6 %
  • Transferred admission program
To achieve Primary PCI for STEMI for transferred patient (<120 minutes) is very difficult or not possible in Bangkok-Thailand.
  • Encouraging “Pharmaco-invasive” approach
    • Thrombolytic therapy in 30 minutes in the first (non PCI) hospital
    • Transfer to Bangkok Heart Hospital
    • Coronary angiogram-PCI in 3-24 hours from thrombolytic treatment time
  • Transfer to Bangkok Heart Hospital for Rescue PCI, Late or Delay PCI.