The procedural success of primary angioplasty in a tertiary care center in Pakistan.

Objective: This study was conducted to evaluate the procedural success of primary angioplasty in terms of TIMI flow and myocardial blush grade (MBG).

Methods: We used cross-sectional population data of the patients who underwent primary PCI in Emergency Angiography department of Punjab Institute of Cardiology, Lahore from January 2021 to September 2021. TIMI flow and myocardial blush grades (MBG) were assessed before and after the procedure. All PCIs in which there was improvement in blood flow in infarct related artery of ≥2 grades in TIMI flow and/or in MBG were considered successful.

Results: A total of 106 patients were enrolled, 91 patients were male and 15 patients were female with the age range from 22 to 75 (48.7 ± 11.8) years. TIMI flow and MBG was improved ≥ 2 grades in 69 and 58 patients respectively. Improvement in TIMI flow was noted similar in all three vessels. Overall 65% patients showed improvement in TIMI flow and 55% in MBG. Onset of chest pain to balloon time was the most important parameter, shorter the time better the result. The patients in whom MBG was improved, the time was 234.26 ± 156.06 vs 323.59 ± 252.64 minutes.

Conclusion: Primary angioplasty is quite effective procedure for the restoration of blood flow in acute ST elevation myocardial infarction but still it is far away from the ideal one. Although most patients benefit from primary PCI, a significant minority of individuals do not, particularly if they present late. What could be the ideal therapy, the answer is still to be answered.