Establishing primary angioplasty as the preferred treatment for acute myocardial infarction

To report procedural results and mortality rates from the first 4 years after establishing primary angioplasty as the preferred treatment for acute myocardial infarction in a single Scandinavian centre.

From August 1995 to October 1999 all patients with the diagnosis of suspected acute myocardial infarction (n = 529, mean age 62 +/- 13 years, 72% men), either transferred (73%) or directly admitted to our institution for coronary angiography with the intention of performing primary percutaneous coronary intervention (primary PCI), were prospectively registered. Procedural success in terms of residual stenosis < or = 30% and a final Thrombolysis in Myocardial Infarction (TIMI) 3 flow was achieved in 94 and 85% of patients treated, respectively. In-hospital delay and procedure times decreased significantly during the 4-year study period. A low in-hospital mortality was observed in each of the 4 years studied (8.7, 8.7, 7.7 and 6.0%).

In a centre with both directly admitted and transferred patients primary angioplasty can be established as the preferred treatment for acute myocardial infarction with an initially low complication and mortality rate. During the first years after implementing the primary angioplasty programme a learning effect can be anticipated with reductions in procedural times.