August 30, 2011 – Primary percutaneous coronary intervention (PCI) is the best reperfusion therapy for patients presenting with acute ST-elevation myocardial infarction. Researchers used the Western Denmark Heart Registry to describe the implementation of primary PCI in Denmark. Their study (including almost 10,000 patients) showed that a strategy with early diagnosis, based on electrocardiogram (ECG) recording in the ambulance and directing the patients straight to the catheterization laboratory in the primary PCI center, was associated with a lower mortality. The data was presented this week at the annual meeting of the European Society of Cardiology (ESC) in Paris.
Direct access to PPCI is unfortunately still not possible in many European countries. A survey from 2007/8 showed that only 40 percent of European patients with ST-elevation myocardial infarction are treated with primary PCI.
The Stent for Life (SFL) Initiative launched by the ESC, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and EuroPCR (the official congress of the EAPCI) is aiming to support the implementation of primary PCI in the ESC countries. Selected target countries are Bulgaria, Egypt, France, Greece, Italy, Portugal, Romania, Serbia, Spain and Turkey.
The barriers for implementation are a complex mix of medical, organizational, patient-related, regulatory and economic factors, and differ from country to country. Therefore, the action plan for implementation is tailored to the specific needs of each country and is managed at country level by the country SFL Initiative and supported by national cardiology societies. Preliminary data from several countries show an increase in the numbers of primary PCIs performed after the SFL action plan was launched. More detailed information about changes in availability of primary PCI in Europe will be available next year where the result of the ongoing 2011 survey will be presented.
The activities at the national level are undertaken in close collaboration with the Emergency Medical Service and transportation protocol, and campaigns are worked out to decrease treatment delay. System delay can be decreased by an effective pre-hospital diagnosis and triage.
Reduction of patient delay in contacting services is another main target. An important strategy for the Stent for Life Initiative is to launch public awareness campaigns about acute coronary syndrome (ACS) symptoms in order to encourage patients to call the Emergency Medical Services directly in the event of an acute onset of chest pain.
For more information: www.escardio.org