Introduction and objectives: The geographic characteristic and healthcare facilities of the region of Murcia, Spain, are enough to assure that coronary angioplasty can be carried out in acute myocardial infarction according to current guidelines. The development of a regional program for coronary intervention in acute myocardial infarction may increase the number of patients who would benefit from reperfusion therapy in general and primary angioplasty in particular.
Material and methods: The program was initiated in April 2000 and had four steps: 1) Establishment of primary angioplasty as the treatment of choice of acute myocardial infarction in the regional reference hospital. 2) Application of phase 1 to a second hospital located 10 kilometers away from the reference hospital. 3) Extension of phase 1 to the entire city of Murcia. 4) Provision of facilities for coronary angioplasty in acute myocardial infarction to all patients in the region.
Results: Between January 2000 and August 2001, 392 angioplasties were performed for acute myocardial infarction. Primary angioplasty was performed in 92% and 85% of the patients with an indication for reperfusion therapy in phase 1 and 2, respectively. The median delay (indication to beginning of procedure) was 25 and 35 minutes in phases 1 and 2, respectively. Total mortality was 11,5% (5,2% in patients without shock at admission).
Conclusions: The design of a regional program of primary angioplasty may increase the number of patients who receive reperfusion therapy in compliance with current recommendations for the treatment of acute myocardial infarction.