Procedural Trends and Clinical Outcomes of Primary PCI in STEMI Patients at Tertiary Hospital in Bangladesh

Abstract

Primary percutaneous coronary intervention (PCI) is the standard of care for ST-elevation myocardial infarction (STEMI) in optimal settings. However, real-world procedural trends and outcomes data from tertiary hospitals in low- and middle-income countries like Bangladesh are limited but crucial for quality improvement. This study aimed to analyze the procedural characteristics and outcomes of patients with STEMI undergoing primary PCI at tertiary cardiac centers in Bangladesh. This single center, prospective observational study was conducted at Metropolitan Medical Centre Ltd. (Private Chamber), from January to December 2024. A purposive sample of 227 consecutive STEMI patients treated with primary PCI was enrolled. Data on patient demographics, procedural details (including door-to-balloon time, vascular access, stent type), and in-hospital outcomes (mortality, heart failure, bleeding, stroke) were collected. Analysis was performed using MS Office tools, primarily Excel. Among 227 patients (mean age 54.8 years, 78.0% male), the median door-to-balloon time was 85 minutes (IQR 65-120), with 64.8% achieving ≤90 minutes. Transradial access (82.4%) and drug-eluting stents (94.3%) were predominantly used. In-hospital mortality was 4.8%. Achieving door-to-balloon time ≤90 minutes was significantly associated with lower mortality (2.7% vs. 8.8%, p=0.048) and less heart failure (8.8% vs. 18.8%, p=0.026). Primary PCI in Bangladeshi tertiary centers demonstrates strong alignment with contemporary standards. The significant survival benefit linked to timely intervention highlights the critical need to strengthen national STEMI networks for further outcome optimization.  

CBMJ 2026 July: Vol. 15 No. 02 P:290-295