Evaluation of Barriers of Achieving Timely Primary Percutaneous Coronary Intervention in Patients with STelevation Myocardial Infarction in Sulaimani Cardiac Hospital
DOI:
https://doi.org/10.56056/Keywords:
Primary percutaneous coronary intervention, ST elevation myocardial infarction, Total ischemic timeAbstract
Background and objectives: An estimated increase in risk of death exists for patients with ST
elevation myocardial infarction. Primary percutaneous coronary intervention may lower this risk
if only performed on time. The aim of this study is to evaluate the barriers to achieving timely
primary percutaneous coronary intervention.
Methods: This is an observational/cross-sectional study conducted in Sulaimani city, Kurdistan
Region of Iraq, from February 1, 2024, to January 31, 2025, on 200 patients with ST elevation
myocardial infarction, assessment of time intervals from symptom onset to balloon, and the factors
contributing to delay of primary percutaneous coronary intervention included in the questionnaire.
Results: Most of the patients (80.1%) were male; the mean age was 60.69 ± 12.16 years. 132
patients, 69.1%, had a timely door to balloon time (≤ 60 minutes). The median door-to-balloon
time was 50 minutes (IQR 25-75: 10-10200 minutes). Median total ischemic time was 380 minutes
(IQR 25-75: 60-2950 minutes). 19 (10%) had timely total ischemic time (≤ 120 minutes).
statistically significant correlation with gender, door in to door out time, symptom to door time,
and door to balloon time (P = 0.016, <0.001). Barriers that significantly prolong total ischemic
time were patient delay, non-percutaneous coronary intervention-capable center delay, delay
during transfer to the PCI center (P <0.001), and delay team activation.
Conclusion: Timely reperfusion is the mainstay of acute STEMI management. This study
discovered that the main barriers of timely primary percutaneous coronary intervention are a
patient’s delay to present to the hospital, longer duration of remaining in non-PCI facility hospital,
and delaying during transferring to PCI-capable center. Focusing on patients’ education and
alertness programs for acute chest pain are essential for enhancing total ischemic time.
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