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Related Experiment Video

Updated: Jun 17, 2026

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Published on: October 14, 2016

Kentucky pilot project for primary PCI without onsite CABG.

John Myers¹, Guy Brock, Savitri Appana

¹University of Louisville, School of Public Health and Information Sciences, Department of Bioinformatics and Biostatistics, 485 East Gray Street, Louisville, KY 40292, USA. john.myers@louisville.edu

The Journal of the Kentucky Medical Association

|December 17, 2009

Summary

This summary is machine-generated.

Primary Percutaneous Coronary Intervention (PCI) outcomes are not significantly affected by the availability of onsite emergency surgical backup. Hospitals without backup capabilities can perform primary PCI, with appropriate restrictions, potentially expanding access to this critical procedure.

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Published on: April 17, 2021

Area of Science:

Cardiology
Interventional Cardiology
Health Services Research

Background:

Current guidelines recommend onsite surgical backup for primary Percutaneous Coronary Intervention (PCI).
This recommendation is based on the potential need for emergency surgical intervention during PCI procedures.
The necessity of this backup in all facilities performing primary PCI remains a subject of investigation.

Purpose of the Study:

To evaluate the safety and efficacy of primary PCI in facilities lacking onsite emergency surgical backup.
To compare outcomes of primary PCI between hospitals with and without immediate surgical support.

Main Methods:

Analysis of data from two Kentucky hospitals performing primary PCI without onsite surgical backup for over three years.
Comparison of outcomes (mortality, cardiac arrest, emergency surgery, door-to-balloon time) with facilities that have surgical backup.
Hospitals were matched for size and proximity to backup facilities.

Main Results:

No significant differences were observed in mortality rates between facilities with and without onsite surgical backup.
Key outcome variables, including cardiac arrest, need for emergency surgery, and door-to-balloon times, showed no significant variation.
The study indicates that the absence of onsite surgical backup did not negatively impact primary PCI outcomes.

Conclusions:

Existing recommendations for primary PCI may require revision.
The study supports allowing facilities without onsite surgical backup to perform primary PCI, provided certain conditions are met.
Restrictions based on surgeon experience and facility volume are recommended for facilities performing primary PCI without onsite surgical backup.