Outcomes of Primary Percutaneous Coronary Intervention at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Adhikari, Chandra Mani; Bhatta, Yadav Kumar Deo; Malla, Rabi; Maskey, Arun; Rajbandari, Rajib; Regmi, Shyam Raj; Sharma, Ranjit; Kansakar, Subodh; Nepal, Himanshu; Shrestha, Nagman; Pandey, Rabindra; Prajapati, Dipankar; Raut, Roshan; Dhungana, Murari; Yadav, Dharma Nath; Rauniyar, Binay Kumar; Kc, Man Bahadur

doi:10.3126/jaim.v2i1.7629

Cited by 6 publications

(11 citation statements)

References 24 publications

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“…In this study, average age of patients was 57.39 years. This finding is similar to the previous studies done in our country 9,10 . About 12% of cases were below 40 years of age, youngest patient being 24 years of age.…”

Section: Discussionsupporting

confidence: 94%

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Study of clinical profile and outcomes of Percutaneous Coronary Intervention in ST Elevation Myocardial Infraction

Koirala¹,

Gajurel²,

Poudel³

et al. 2019

Nepalese Heart J.

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Background and Aims: Percutaneous Coronary Intervention (PCI) is the preferred method of revascularization in Acute ST Elevation Myocardial Infarction (STEMI). Our aim was to study the clinical profile and outcomes of patients who underwent PCI for STEMI at tertiary cardiac centre of Nepal. Methods: It is a retrospective, single centre study, performed at Tribhuvan University, Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal. All patients who underwent PCI for STEMI from November 2015 to July 2018 were enrolled in this study. All the data were collected from hospital registry and cath lab records. Results: The Study showed that out of 232 patients who presented with STEMI, 74.5% were male with average age of 57.39 years. The mean time of presentation after onset of symptom/s was 17.5 hours. About 66% patients presented in less than 12 hours of symptoms onset, 21% presented at 12-24 hours of symptoms onset and 13% patients presented late. Primary PCI was done in 87% of patients. Almost all patients (98.2%) underwent coronary artery stenting with drug eluting stents. Multivessel PCI during index procedure was done in 7 patients. TIMI III flow following PCI was achieved in 97% cases. Average LVEF at discharge was 44.73%. There were 8 deaths, all after Primary PCI. In-hospital mortality rates for patients presenting with and without cardiogenic shock were 38.46% and 1.59% respectively. The overall mortality rate was 3.98%. Conclusion: This study has reemphasized that PCI is effective in the management of STEMI cases in Nepal with improving mortality rates and decreasing complications. Minimizing the delayed presentation after the onset of symptoms should be one of the prime focuses for effective management of STEMI.

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Section: Discussionsupporting

confidence: 94%

“…The percentage of diabetes (28.2%) was similar to other studies. While 50% of our patients were current or former smoker, this varied from 34% to 76.47% in other studies 9,10,11 . One of the major determinants of outcome in MI is the time interval between onset of symptom to revascularization.…”

Section: Discussioncontrasting

confidence: 57%

Study of clinical profile and outcomes of Percutaneous Coronary Intervention in ST Elevation Myocardial Infraction

Koirala¹,

Gajurel²,

Poudel³

et al. 2019

Nepalese Heart J.

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“…It is similar to other studies where it varied from 55-80% . 4,[14][15][16] In contrast to other studies, 4,15 smoking was more prevalent in women as compared to men (51% vs 35%, p value 0.03). This shows higher prevalence of smoking in women with STEMI and as this is one of the major risk facor for CAD, every effort should be applied so as to help quit smoking.…”

Section: Inhospital Mortalitymentioning

confidence: 94%

“…6 Men were also predominant in studies conducted in Nepal. In Kathmandu, men were 82%, 14 in Pokhara 51.7% 15 and in the Western Nepal ACS registry 62.3%. 16 Women were about 6 years older than men.…”

Section: Inhospital Mortalitymentioning

confidence: 97%

Gender Difference in Presentation, Management and Inhospital Mortality in St Elevation Myocardial Infarction in a Tertiary Cardiac Center

Shrestha

Arun²,

Anil³

et al. 2015

J Nobel Med Coll

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Background: Studies have shown that women are less likely to receive reperfusion therapy and have higher inhospital death in ST Elevation myocardial infarction(STEMI) as compared to men. This study aims to examine presentation, acute therapy, and inhopital mortality in women admitted with diagnosis of acute STEMI in a tertiary care cardiac center.Methods: Patients admitted with diagnosis of acute STEMI from 1st June 2013 to 31st May 2015 were included in the study. Gender difference in baseline characterstics, comorbidities, prehospital delay, type of treatment received and inhospital death were measured. Variables that might have impact on inhospital deaths were analyzed on multivariate regression analysis to find out other variables adjusted effect of gender on inhospital deaths.Results : Majority of the patients were men (Men 69% vs women 31%). Women were older, were more likely to be diabetics and smoker. Prehospital delay was more in women ( women 22 hours vs men 12 hours, p value-0.02).About 46% of both men and women received reperfusion therapy. There was more inhospital mortality in women (women 13.5% vs men 6.5%, p value – 0.02). Women had more inhospital mortality even after adjustment with other covariables (OR = 3.110, 95% CI = 1.411-6.902, p value-0.005).Conclusion : Women were more likely to be elderly, diabetics, smoker and presented later than men after symptoms onset. Women received reperfusion therapy similar to that of men. After adjustment with other covariates, women remained a significant variable to inhospital death.Journal of Nobel College of Medicine Vol.4(1) 2015: 6-11

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“…Few studies have been published which compare the early outcome of PPCI in acute STEMI. 8 Outcomes related to thrombolysis and conservative treatment is not well studied. So, the general objective of the study was to know the short-term adverse outcome in hospital and after hospital discharge up to 30 days in acute STEMI in all three PPCI, thrombolysis and conservatively managed groups.…”

Section: S T Elevation Myocardial Infarction (Stemi) Ismentioning

confidence: 99%

Short Term Outcome of Acute ST Elevation Myocardial Infarction in a Tertiary Care Cardiac Center

Shrestha

Gajurel

Poudel

et al. 2020

Journal of Institute of Medicine

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Introduction Acute ST Elevation Myocardial infarction (STEMI) is a cardiovascular emergency and is associated with significant adverse short and long-term outcome. The objective of this study was to determine the short-term outcome in terms of heart failure, myocardial reinfarction, stroke, hospital readmission and mortality in patients admitted with STEMI MethodsIt was a prospective observational study conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu from May 2014 to April 2015. All patients admitted with diagnosis of STEMI during study period were enrolled. Patients were treated on the basis of existing guidelines. Mode of management, adverse outcomes and mortality of patients during the study period were evaluated. The discharged patients were followed up for 30 days. Statistical analysis was performed with SPSS version 20. Ethical approval was taken from the Institutional Review Committee of Institute of Medicine. ResultsThe median duration of presentation was 20 hours, and only 40% of the patients presented within 12 hours of symptom onset. Primary PCI was performed in 50 (33%), thrombolysis was performed in 29(19%) and conservative medical management was done in 72 (48%) patients. Overall outcome occurred in 52 (37.7%) patients. In hospital and 30 day mortality was 14 (9.2%) and 17 (11%) respectively. Heart failure was present in 28(18.5%), myocardial reinfarction 8 (5%), stroke 4 (2.6%), and hospital readmission was 18 (12%). Conservatively treated patients had significantly more adverse outcomes (p=0.02). More patients in conservatively managed group had hospital readmission. (p=0.04) ConclusionThere were more overall adverse outcomes in conservatitley managed group which is mainly due to more hospital readmission.

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Outcomes of Primary Percutaneous Coronary Intervention at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Abstract: Background and Aims-

Cited by 6 publications

References 24 publications

Study of clinical profile and outcomes of Percutaneous Coronary Intervention in ST Elevation Myocardial Infraction

Study of clinical profile and outcomes of Percutaneous Coronary Intervention in ST Elevation Myocardial Infraction

Gender Difference in Presentation, Management and Inhospital Mortality in St Elevation Myocardial Infarction in a Tertiary Cardiac Center

Short Term Outcome of Acute ST Elevation Myocardial Infarction in a Tertiary Care Cardiac Center

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