Coronary angioplasty in the acute phase of myocardial infarction in a low-volume center

The efficacy of coronary angioplasty in the treatment of acute myocardial infarction was assessed in a low volume centre. Between January 1994 and May 1999, 148 consecutive patients (mean age 59 years, 81% men) with acute myocardial infarction, admitted within 12 hours, were included in this retrospective analysis. On admission, 14% of patients were in cardiogenic shock. The average time between the onset of chest pain and arrival at hospital was 244 +/- 183 mins. Reperfusion (TIMI 3 flow) was obtained on average 111 +/- 60 mins after arrival at hospital and 81 mins after informing the on-call team. After angioplasty, residual stenosis < 50% was obtained in 91% of cases. TIMI 3 flow was obtained in 85% of cases (TIMI 2 + 3 in 93% of cases). Over the years, the delay before treatment decreased and the results of angioplasty improved. In the last 79 patients, residual stenosis < 50% was obtained in 95% of cases, TIMI 3 flow in 87% of cases (TIMI 2 + 3 in 97% of cases). The stenting rate increased from 16% before 1997 to 61% thereafter. The hospital mortality was 4%. Direct or salvage angioplasty in the first 12 hours of myocardial infarction in some low volume centres may be carried out safely with intervention times and success rates comparable to those reported in the literature.