In search of lost time: modern treatment of acute myocardial infarction.

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In search of lost time modern treatment of acute
myocardial infarction.

• Marek Kondys, MD
• Pawel Buszman, MD, FESC, FACC
• Interventional Cardiology Department, AHP,
  Dabrowa, Poland

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ESC STEMI/PCI Guidlines
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Upper-Silesia24h/7d cath labs for AMI
treatment20 year experience!
Population of Upper-Silesia 4,9 mln
Czestochowa
Dabrowa G.
Zabrze
KATOWICE GCM, SLAM
Transportation Max. 30 min. to the nearest cath
lab
Rybnik
Bielsko
AHP Cath labs
Ustron
1 mln.
50 km
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ECG transmission through mobile phoneLIFE NET
SYSTEM (MEDTRONIC)
Suspicion of ACS-ECG in ambulance
Transmission of ECG from ambulance to cath lab in
a reference center
acceptation by interventional cardiologist
Low risk ACS or non-coronary chest pain
STEMI or High Risk ACS
Local hospital
Reference center with cah lab
American Heart of Poland, Ltd www.klinikiserca.pl
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Transmitted ECG
ECG at admission to ICD
American Heart of Poland, Ltd www.klinikiserca.pl
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Primary PCI
Prox. LAD occlusion
After stenting
Predilatation and stent implantation
American Heart of Poland, Ltd www.klinikiserca.pl
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The end of the procedure
ECG after 3 days
American Heart of Poland, Ltd www.klinikiserca.pl
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Silesian Registry of ACS October 2003 September
2004 (12 month)

• In-hospital mortality vs treatment modality

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Silesian Registry of ACS October 2003 September
2004 (12 miesiecy)

• Treatment strategy Time Prognosis

30 day mortality


Time Chest pain hospital admission
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Improving Primary PCI

• Reperfuse more people with PPCI
• Reperfuse faster
• Reperfuse better
• STOP MYOCARDIAL INJURY
• Restore normal myocardial metabolism
• Prevent myocardial injury
• Enhance myocyte recovery