PRIMARY PTCA IN A RURAL HOSPITAL

The results of primary percutaneous transluminal coronary angioplasty (PTCA) to treat patients with acute myocardial infarction in a rural h ospital were reviewed. Thirty-five patients presenting with acute myoc ardial infarction, including 40% considered high risk, were treated us ing the strategy of primary angioplasty. Following cardiac catheteriza tion, two patients were found to have anatomy deemed unsuitable for pr imary angioplasty and subsequently underwent urgent coronary artery by pass graft (CABG) surgery. Thirty-three patients underwent primary ang ioplasty with a procedural success rate of 94%. Procedural success was defined as reduction of the infarct arteries stenosis to less then 50 % and the establishment of TIMI-III flow. Six percent of these patient s required urgent CABG surgery because of unsuccessful angioplasty. In -hospital cardiac mortality was 3%. Six month follow-up was achieved f or all patients. There were no cardiac deaths following hospital disch arge. Recurrent ischemia occurred in 17% of the patients. Favorable in -hospital and late results were achieved. This review indicates that t he strategy of primary angioplasty to treat myocardial infarction may be successfully applied in a rural setting.