Outcome of percutaneous coronary intervention in acute coronary syndromes: from clinical trials to clinical practice

Early angiography and revascularisation are beneficial for patients with non-ST segment elevation myocardial infarction (NSTEMI). However, the Prospective Registry of Acute Ischaemic Syndromes in the UK (PRAIS-UK) demonstrated low levels of revascularisation in the UK in patients at high cardiovascular risk.
In the study described here, the authors attempted to streamline their referral process for acute revascularisation and conducted an audit to quantify the delay and to monitor outcomes. There were 1,640 percutaneous coronary interventions (PCIs) in West Yorkshire during the year 2000; of these 45% were acute interventions. The catheter laboratory database identified 212 acute PCI patients with a Leeds city postcode.
Average times from admission to angiogram, angiogram to intervention, and intervention to discharge are described, as are patient characteristics. Acute and six-month outcome data are given for the whole cohort and for a high-risk subgroup. The six-month composite rate of death and myocardial infarction was lower than that observed in PRAIS-UK. The data show that the time delay between admission and intervention can be kept to a reasonable level.