Procedural Success & In-Hospital Outcomes of Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction: A Retrospective Cohort Study.
DOI:
https://doi.org/10.58889/PJCVI.5.2.55.64Keywords:
Primary Percutaneous Coronary Intervention, ST-Elevation Myocardial Infarction, Procedural Success, In-Hospital Outcomes, TIMI FlowAbstract
Background: Cardiovascular disease is the leading cause of mortality globally and in Pakistan, where ischemic heart disease accounts for ~29.1% of deaths. Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy for ST-elevation myocardial infarction (STEMI), offering superior outcomes when performed within guideline-recommended timelines. However, region-specific data from Khyber Pakhtunkhwa (KP) remain limited despite a rising burden of coronary artery disease. This study aimed to evaluate procedural success and in-hospital outcomes of primary PCI in STEMI patients at a major tertiary care center in KPK, Pakistan.
Methodology: This retrospective, single-center observational study included 800 consecutive STEMI patients undergoing primary PCI at Lady Reading Hospital MTI, Peshawar, between January 2025 to June 2025. Procedural success was defined as TIMI grade III flow with <30% residual stenosis without major adverse cardiac events (MACE). Primary endpoints included procedural success, in-hospital mortality, and MACE. Analyses were conducted using SPSS v26.0, including multivariable logistic regression.
Results: Among 800 patients (mean age 55 ± 10 years; 72% male), hypertension (44%), smoking (40%), and diabetes (36%) were common risk factors. Anterior wall MI predominated (54%), with the left anterior descending artery as the culprit in 51%. Mean door-to-balloon time was 45 ± 15 minutes, with 95.6% achieving ≤90 minutes. Procedural success was 96%, with TIMI III flow in 94%. In-hospital mortality was 2.25%, and stent thrombosis occurred in 1.25%, with no stroke, major bleeding, or emergency CABG. Cardiogenic shock was the strongest predictor of mortality (OR 8.94; p<0.001).
Conclusion: Primary PCI demonstrated high success and favorable outcomes, aligning with national and international benchmarks, reflecting effective guideline-based care in a resource-limited setting.
