First Medical Contact to Device Time in the Thailand
Percutaneous Coronary Intervention (PCI) Registry
Nattawut Wongpraparut MD*, Chunhakasem Chotinaiwattarakul MD**, Pradit Panchavinnin MD*,
Damras Tresukosol MD*, Rewat Phankingthongkum MD*, Wiwun Tungsubutra MD*,
Rungtiwa Pongakasira BSc***, Khemajira Karaketklang MPH****, on behalf of Thailand National PCI Registry
Affiliation :
* Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
** Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
*** Research Division, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
**** Department of Medicine, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Objective : The aim of this study is to evaluate the first medical contact (FMC) to device time in the Thai national PCI
registry 2006, and its effect on the clinical outcome.
Material and Method: Thailand national PCI registry enrolled 4,156 patients who underwent PCI from the all catheterization
laboratories in Thailand between May 1st and October 31st, 2006.
Results : 581 patients with acute myocardial infarction (AMI), 352 patients underwent primary angioplasty, 229 patients
underwent rescue angioplasty/facilitated PCI or after successful thrombolytic. Median FMC to device time in primary
angioplasty group was 115 minutes (range 24-1335 minutes); only 29.8% of patients who able to achieve FMC to device
time ≤90 minutes. Cardiogenic shock was significant lower if FMC to device time ≤90 minutes (2.1% (1/48) versus 12.4%
(14/113) if FMC to device time >90, p = 0.040). In-hospital mortality occurred for 4.8% (2/48) if FMC to device time ≤90
minutes and was 8.8% (10/113) if FMC to device time >90 minutes, p = 0.510). Death occurred in 4.2% (2/48) if FMC to
device time ≤90 minutes, 6.3% (5/79) if FMC to device time between 91-180 minutes, 6.7% (1/15) if FMC to device time
between 181-270 minutes, 42.9% (3/7) if FMC to device time between 271-360 minutes and 8.3% (1/12) if FMC to device
time >360 minutes, (p = 0.040).
Conclusion : FMC to device time is strongly associated with the risk of cardiogenic shock and mortality. In Thailand national
PCI registry in 2006, the majority of the patients did not receive primary PCI in timely fashion.
Keywords : First medical contact to device time, Door to balloon time, ST elevation myocardial infarction (STEMI), Mortality
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