Key result
Primary PCI for STEMI under the ESI scheme is associated with ~11% in-hospital MACE.
Why the study?
The authors wanted to assess the clinical profile and in-hospital outcomes of PPCI for STEMI among ESI beneficiaries in India.
Observational (n=122)
Primary PCI in Indian ESI beneficiaries with STEMI demonstrates high procedural success and acceptable overall mortality, though mortality remains high in those presenting with cardiogenic shock.
BACKGROUND We wanted to assess the clinical profile and in-hospital outcomes of Primary Percutaneous Coronary Intervention (PPCI) for ST-segment Elevation Myocardial Infarction (STEMI) in India in ESI (Employee Scheme Insurance) beneficiaries. METHODS From January 2017 to July 2018, 122 consecutive acute STEMI patients undergoing PPCI under ESI scheme were included in the study. Patients’ clinical profile, detailed procedural characteristics, time variables along with in-hospital major adverse cardiovascular events (MACE) were also assessed. RESULTS 122 patients underwent primary PCI during the study period. In the study, mean age was 55.23 (27 - 85) years; 94 (77.04 %) were males; 53 (43.44 %) were hypertensives; 38 (31.14 %) were smokers; and 44 (36.06 %) were diabetics. Ten (8.19 %) patients were in cardiogenic shock (CS). Anterior myocardial infarction was present in 70 (57.37 %) patients. The median chest-pain-onset to hospitalarrival-time was 270 (70 - 720), door-to-balloon time was 55 (20 - 180) and total ischemic time was 325 (105 - 780) minutes. In-hospital adverse events occurred in 14 (11.4 %) patients [death 8 (6.55 %), major bleeding 2 (1.63 %), urgent CABG 3 (2.45 %) and stroke 1 (0.81 %)]. Seven patients with cardiogenic shock died. CONCLUSIONS The mean age of our cohort was 55.23 years. In our study, majority of patients were males (77.05 %), hypertension was associated with 43.44 %, and diabetes was associated with 36.06 % of patients. Procedural success was achieved in 95.89 %. The overall in-hospital mortality was 6.55 % and 70 % in the cardiogenic shock subset.
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Devegowda et al. (2020) conducted an observational in ST-segment Elevation Myocardial Infarction (STEMI) (n=122). Primary Percutaneous Coronary Intervention (PPCI) was evaluated on In-hospital major adverse cardiovascular events (MACE). Primary percutaneous coronary intervention in STEMI patients under the ESI scheme in India resulted in an in-hospital MACE rate of 11.4% and an overall in-hospital mortality rate of 6.55%.
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