BACKGROUND: Acute myocardial infarction (AMI) remains a major cause of morbidity and mortality. This study aims to outline the national profile of percutaneous coronary intervention (PCI) in the setting of AMI, analyzing different time periods and geographic regions, with focus on primary PCI and adjunctive pharmacological and mechanical treatments. METHODS: Data from 20,004 patients with ST elevation myocardial infarction (STEMI) undergoing PCI and included in the CENIC Registry (National Center of Cardiovascular Interventions) from January 2006 to December 2010 were included in this study. Data were obtained from 252 centers located in 22 states from five different geographic regions in the country. RESULTS: Primary PCI accounted for 57.8% of PCI performed in the setting of AMI, followed by elective PCI after STEMI (35.7%), rescue PCI (6.1%) and facilitated PCI (0.4%). The evolution over time showed a progressive increase in the number of primary PCIs in Brazil, from 56.7% in 2006 to 71.6% in 2010. The mean door-to-balloon time of primary PCI in Brazil during this period was 2 hours. Thrombus aspiration increased from 0.4% in 2006 to 8.2% of cases in 2010. Procedural success rate was 93.8%, while in-hospital mortality was only 2.8%. CONCLUSIONS: PCI in the setting of STEMI has improved from 2006 to 2010, although heterogeneously in the different regions of Brazil, due to increased primary PCI rates and higher use of thrombus aspiration devices, which have not been incorporated in the routine practice. Investments in staff training and implementation of clinical protocols are essential to optimize the door-to-balloon time and improve clinical outcomes.
Myocardial infarction; Angioplasty; Stents; Registries; Clinical protocols
