AIMS: To describe the safety of immediate retransfer to community hospitals following primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: In a cohort of 246 consecutive patients transferred to a tertiary institution who all underwent primary or rescue PCI, 166 (67%) were immediately retransferred back. The retransfer occurred only if they were haemodynamically stable and had undergone an uncomplicated procedure. In-hospital adverse events were assessed in each referral hospital. Patients had a mean age of 59 years, presented an anterior MI in 39%, and 91% were in Killip class 1. In this cohort, 75% of patients underwent primary PCI and 25% received rescue PCI. A transradial approach was used in 74% of patients. During ambulance transport back to the referral hospital, no adverse events occurred. In-hospital outcomes were favourable, with low death (2.4%), reinfarction (3.6%) and stroke (1.2%) rates. TIMI major bleeding occurred in 1.8% (catheter-related in 0.6%). CONCLUSIONS: In this carefully selected population of STEMI patients, immediate retransfer to the referral hospital following primary or rescue PCI is feasible in more than 2/3 of patients and associated with a low risk of major clinical adverse events.
AIMS: To describe the safety of immediate retransfer to community hospitals following primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: In a cohort of 246 consecutive patients transferred to a tertiary institution who all underwent primary or rescue PCI, 166 (67%) were immediately retransferred back. The retransfer occurred only if they were haemodynamically stable and had undergone an uncomplicated procedure. In-hospital adverse events were assessed in each referral hospital. Patients had a mean age of 59 years, presented an anterior MI in 39%, and 91% were in Killip class 1. In this cohort, 75% of patients underwent primary PCI and 25% received rescue PCI. A transradial approach was used in 74% of patients. During ambulance transport back to the referral hospital, no adverse events occurred. In-hospital outcomes were favourable, with low death (2.4%), reinfarction (3.6%) and stroke (1.2%) rates. TIMI major bleeding occurred in 1.8% (catheter-related in 0.6%). CONCLUSIONS: In this carefully selected population of STEMI patients, immediate retransfer to the referral hospital following primary or rescue PCI is feasible in more than 2/3 of patients and associated with a low risk of major clinical adverse events.
Authors: Shukri M Al-Saif; Khalid F Alhabib; Anhar Ullah; Ahmed Hersi; Husam Alfaleh; Khalid Alnemer; Amir Tarabin; Ahmed Abuosa; Tarek Kashour; Mushabab Al-Murayeh Journal: J Saudi Heart Assoc Date: 2011-10-19