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  • Ppci 10.11.22

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    Nayer Sultana
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    This document summarizes the findings of a registry on primary percutaneous coronary intervention (PPCI) at a single center in Bangladesh between 2014 and 2022. Some key findings from the registry include: - A total of 1280 patients underwent PPCI, with the average door-to-balloon time being 72.7 minutes. - Risk factors for heart disease like smoking, diabetes, hypertension and family history were common. - Most patients had single or double vessel coronary artery disease. - Thrombus aspiration was performed in 79.3% of cases. - In-hospital complications included arrhythmias, blood loss, and heart failure.

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    PPCI 10.11.22

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    This document summarizes the findings of a registry on primary percutaneous coronary intervention (PPCI) at a single center in Bangladesh between 2014 and 2022. Some key findings from the registry include: - A total of 1280 patients underwent PPCI, with the average door-to-balloon time being 72.7 minutes. - Risk factors for heart disease like smoking, diabetes, hypertension and family history were common. - Most patients had single or double vessel coronary artery disease. - Thrombus aspiration was performed in 79.3% of cases. - In-hospital complications included arrhythmias, blood loss, and heart failure.

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    © All Rights Reserved
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    7 views20 pages

    Ppci 10.11.22

    Uploaded by

    Nayer Sultana
    This document summarizes the findings of a registry on primary percutaneous coronary intervention (PPCI) at a single center in Bangladesh between 2014 and 2022. Some key findings from the registry include: - A total of 1280 patients underwent PPCI, with the average door-to-balloon time being 72.7 minutes. - Risk factors for heart disease like smoking, diabetes, hypertension and family history were common. - Most patients had single or double vessel coronary artery disease. - Thrombus aspiration was performed in 79.3% of cases. - In-hospital complications included arrhythmias, blood loss, and heart failure.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 20

    Primary PCI: a single-centre

    registry

    Prof. Dr. Nazir Ahmed


    MBBS, FCPS
    Consultant Cardiologist,
    National Heart Foundation Hospital & Research Institute,
    Dhaka
    Bangladesh
    Potential conflicts of interest

    Speaker's name: Nazir Ahmed

     I do not have any potential conflict of interest


    YEAR-WISE CATH-LAB PROCEDURES from 1999 to August 2022

    18862

    16740 16836
    15084 15284 15042
    13687 13921
    12478
    11642
    10324
    8669

    6536 6941
    6064
    5407
    4550 4888
    3981
    3159
    2375
    1300 1713
    435

    Year Year Year Year Year Year Year Year Year Year Year Year Year Year Year Year Year Year Year Year Year Year Dec- 22-
    1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 21 Aug

    Total Procedures = 217,752


    Total PCI=59,292
    National Heart Foundation Hospital
    & Research Institute
    • A non government non profit organization
    • Developed under Public Private Partnership
    (PPP)
    • 330 bedded cardiac hospital fully equipped with
    modern tools.
    • Providing modern cardiac treatments at an
    affordable cost.
    Barriers to primary PCI
    • Public awareness/Education

    • Skeptical attitude of patient & their attendants towards


    PPCI kills time.

    • Primary physicians role

    • Transport delay.

    • Trained ambulance staff.

    • COST involved

    • 24X7 Cath Lab/Operator availability

    • Number of Capable PCI centers


    Our steps to Primary PCI

    • Loading dose of DAPT at ER


    • Mostly femoral approach
    • Heparin
    • Culprit vessel only
    • Thrombus aspiration
    • Preferably direct stenting (DES/BMS)
    • GP IIb/IIIa inhibitor depending on thrombus load
    2014 oct –2022 oct
    1200000.00%
    10129
    1000000.00%

    800000.00%

    600000.00%

    400000.00%

    200000.00% 1280

    0.00%
    Total STEMI PPCI
    Gender distribution

    11.80% N=1280

    88.20%

    Male Female
    Age Category
    398
    400
    350 314
    298
    300
    250
    200
    146
    150 110
    100
    50 14
    0
    <30 yrs 31-39 yrs 40-49 yrs 50-59 yrs 60-69 yrs Above 70
    yrs
    Clinical Presentation on
    admossion
    Cardiogenic Conduction
    shock(10.30%) disturbences(11.70%)

    Heart failure(10.90%) Arrhythmias(10.1%)


    Distribution of risk factors PPCI
    86.00%
    90.00%
    80.00%
    70.00% 59.00% 61.40%
    55.00%
    60.00%
    50.00%
    33.30%
    40.00%
    30.00%
    20.00%
    10.00%
    0.00%

    in
    g
    io
    n M ia D
    k s D
    em IH
    o n d /O
    S m
    er
    te
    li pi H
    yp ys ily
    H D am
    F
    Coronary Artery Disease
    63.4%
    70%

    60%

    50%

    40%
    23.4%
    30%
    13.20%
    20%

    10%

    0%
    SVD DVD TVD
    Thrombus Aspiration N=1280

    90.00%
    79.30%
    80.00%
    70.00%
    60.00%
    50.00%
    40.00%
    30.00%
    20.70%
    20.00%
    10.00%
    0.00%
    Done Not Done
    Anti platelet in addition to aspirin
    70.00%

    60.00% 59.00%

    50.00%

    40.00%

    30.00% 25.40%
    20.00% 15.60%
    10.00%

    0.00%
    Clopid Prasugrel Ticagrel
    History of Coronary
    Artery Disease PPCI
    40.00%

    35.00% 33.40%

    30.00%

    25.00%

    20.00%

    15.00%

    10.00%
    6.20% 5.70%
    5.00%
    0.20%
    0.00%
    H/O PTCA H/O CABG H/O MI H/O Angina
    In Hospital Complication
    25.00%

    20.30%
    20.00%

    15.00%
    12.80%
    10.30%
    10.00%

    5.20% 4.80%
    5.00% 3.20%

    0.00%
    Arrhythmia Blood Loss Heamatoma Cardiogenic LVF Death
    Shok
    Door to ballon
    time(PPCI)

    Mean72.70 ± 27.48
    Country level decision making process
    –Key stakeholders
    •Government
    –Ministry of Health & Family Welfare
    –Ministry of Local Government
    –Ministry of Planning
    –Ministry of Finance
    •Non-government
    –Private (Diabetic Association of Bangladesh, National Heart
    Foundation, Kidney Foundation)
    –Civil society (NCDF-Eminence, Cancer Society, etc.)
    •Development partners
    – (World Bank, WHO, UNFPA, USAID, DFID, EC, CIDA, SIDA, GiZ,
    etc.)-Donor consortium.

    (NCDs) in Bangladesh An overview : Prof. Shah MonirHossain, Advisor, Non-Communicable Diseases


    Challenges
    • National policy need to be formulated &
    implemented for PPCI.
    • Budget allocation.
    • Infrastructure development.
    • Developing effective transport system.
    • Skilled man power.
    • Public awareness program.
    • HR and logistics.
    • Effective health insurance program for PPCI.
    Thank You

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