Abstract 2407: Primary PCI at Hospitals Without On-site Cardiac Surgery: Outcomes from the C-PORT Primary PCI registry.
The first randomized Cardiovascular Patient Outcomes Research Team (C-PORT) trial involving primary PCI included outcomes on 226 patients treated with primary PCI. To better assess the safety and efficacy of primary PCI at hospitals without on-site cardiac surgery, the C-PORT primary PCI registry was developed. Since 1999, 5687 patients had primary PCI at 33 registry hospitals, all without on-site cardiac surgery. Prior to initiating primary PCI, all hospitals completed a formal primary PCI development program and outcomes were monitored. The median number of primary PCIs per year per center was 46. The average age of enrolled patients was 61 ± 13 years; 70% were male and 93% were thrombolytic-eligible. The tables below summarizes patient characteristics and outcomes. PCI success is defined from the physician report and based on either categorization of the PCI as successful or unsuccessful, or the angiographic report indicating whether there is a less than 50% residual stenosis and either TIMI 2 or 3 flow or TIMI 3 flow. The median door-to-balloon time was 101 (81,126) minutes. Stents were used in 93% of patients, and a GpIIb/IIIa antagonist in 83% of patients. Recurrent MI occurred in 0.5% and stroke in 0.4%. Bleeding (any source) requiring blood transfusion or vascular surgery or repair occurred in 4.5% of patients. We conclude that after completion a formal primary PCI development program and with on-going outcomes monitoring, primary PCI can be performed safely and effectively at hospitals without on-site cardiac surgery. Outcomes observed at hospitals without on-site cardiac surgery appear to be at least as good as outcomes reported at hospitals with on-site cardiac surgery.