Experience and Outcomes of Primary Percutaneous Coronary Intervention for Patients with ST-Segment Elevation Myocardial Infarction of Tertiary Care Center in Bosnia and Herzegovina

Background: Primary percutaneous coronary intervention (PCI) is an emergent percutaneous catheter intervention in the setting of ST-segment elevations myocardial infarction (STEMI), without previous fibrinolytic treatment. Aim: To evaluate the feasibility and outcomes of primary percutaneous coronary interventions for STEMI in regional tertiary care cardiac centre in Bosnia and Herzegovina. Methods: Between January 2014 and December 2016, consecutive 549 STEMI patients who underwent primary PCI were prospectively enrolled in a primary PCI registry. The most of coronary angiography procedures were performed using the radial artery route. Patient demographics, risk factors, procedural characteristics, time variables and in-hospital events were assessed. Results: On admission, 297 (64.7%) of the patients were current smokers, 234 (42.6%) were hypertensive, 172 (31.3%) were diabetics, and 68 (12.3%) had cardiogenic shock. The mean duration of time from symptom onset to hospital arrival 193±118.2 minutes, and the mean door-to-balloon time was 37±11.3 minutes and median total ischemic time was 265(60-897) minutes. Infarct-related artery (IRA) was the left anterior descending artery in 47.1%, multivessel disease was present in 49.7%. Primary PCI involved balloon dilatation (2.7%) and stent implantation (97.3%). The incidence of postprocedural angiographic no-reflow was 6.7%. All-cause mortality occurred in 17 patients (3.1%). Conclusion: This study has shown feasibility and efficiency in performing of primary PCI with good outcomes in the first regional interventional center in Bosnia and Herzegovina. Experiences and results of our hospital can be very useful in creating primary PCI networks in our countries and developing countries as well.