Primary Percutaneous Coronary Angioplasty for Acute Myocardial Infarction at a Rural Area Hospital--A Great Difference from the Ideal

Background: Primary percutaneous coronary intervention (PCI) is recommended as a standard treatment for acute ST-elevation myocardial infarction (STEMI). We sought to understand how this treatment is implemented in a rural area. Methods: We reviewed charts of acute STEMI patients admitted between February 2001 and October 2005 to Tzu Chi Da Lin General Hospital and managed with primary PCI, We collected baseline information, laboratory data, outcomes and complications. Results: We enrolled 140 patients. 1ean time front chest pain to arrival at the hospital was 178min from arrival to reperfusion was 169min. The success rate was 99.2% (PCI failed in one case). The in-hospital mortality late was 10.7% and the average hospital stay was 9.32 days. The rate of ischemic stroke was 2.1%; no patient had hemorrhagic stroke. WBC counts predicted in-hospital mortality, and use of ACE inhibitors was associated with reduced in-hospital mortality. Conclusion: Patients in rural areas with acute STEMI are usually delayed for treatment and have a higher mortality rate and longer hospitalization. Efforts to improve these outcomes arc warranted.