Primary PCI for STEMI
Primary PCI vs Thrombolytic treatment for STEMI.
Bangkok Heart Hospital Primary PCI for STEMI program
- 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.
- 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
|Median door to balloon time
|Percentage of median door to balloon time <90 Minutes
- 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.