Objective: To evaluate the feasibility and outcomes of primary percutaneous coronary intervention (PCI) as a mode of treatment in acute ST segment elevation myocardial infarction (STEMI). Study Design: Descriptive cross sectional study. Place and Duration of Study: The study was conducted in Army Cardiac Center Lahore, from Nov 2019 to Feb 2020. Methodology: All patients diagnosed as acute ST-segment elevation myocardial infarction during the study period were offered primary percutaneous coronary intervention among treatment options. Patients who chose primary percutaneous coronary intervention were included in the study. Informed consent was taken. Patient demographics, risk factors, time variables, procedural characteristics and in-hospital adverse events were evaluated. Results: On admission, Out of 50, 30 (60%) of the patients were current smokers, 25 (50%) were hypertensive, 22 (44%) were diabetic, and 1 (2%) had cardiogenic shock. The mean time from symptom onset to hospital arrival was 5 hours and the mean door-to-balloon time was 34 minutes. Culprit coronary artery was the left anterior descending artery (LAD) in 56% cases and multi-vessel disease was present in 38% cases. Primary percutaneous coronary intervention involved balloon dilatation (2%) and stent implantation (98%). The incidence of postprocedural angiographic no-reflow was 0%. All-cause mortality was 1%. Conclusion: This study has shown efficiency, feasibility and safety in performing of primary percutaneous coronary intervention with excellent outcomes in Army Cardiac Center Lahore. In order to further improve its outcomes, our goal should be to decrease reperfusion time which can be achieved by reducing patient delay, increasing public awareness and improving the management of first medical contact.

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Objective: To determine the frequency of unidentified Diabetes Mellitus in Acute Myocardial Infarction. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Army Cardiac Centre Lahore, Lahore, from Jan 2020 to Feb 2020. Methodology: Patients (male and females) with acute myocardial infarction both ST Elevation MI and non-ST Elevation MI presenting to cardiac centre were included through consecutive non probability sampling technique. Patients with gestation diabetes mellitus and diabetes type I were excluded. Data was collected through detailed questionnaire covering the necessary variables. Distribution of unrecognized diabetes in these patients were determined through Blood Sugar Fasting and HBA1c levels undersigned by the classified Pathologist. Results: Over the study period, a total of 150 patients were included. 68.6% were males with 40.6% patients suffering from STEMI and 28% with NSTEMI. Among 31.2% females, 12.6% patients had STEMI and 18.6% had NSTEMI. Out of total patients, 40% were known case of diabetes, 26.6% were newly diagnosed diabetics, normoglycemic were 23.3% and impaired fasting blood glucose levels was present in 10% patients. Total 40 (26.6%) patients were those who were first diagnosed diabetes during admission for acute MI management. In unidentified diabetic group STEMI was more common than NSTEMI with male predominance. Conclusion: There is a high frequency of unrecognized diabetes mellitus in patients with acute Myocardial infarction in our population. Therefore, in high risk patients for ischemic heart disease, screening for diabetes is routinely suggested to take timely preventive efforts and avoid complications.

Objective: An experience to evaluate the outcomes, feasibility, effectiveness and safety of transradial approach practice in patients undergoing primary percutaneous coronary intervention for acute ST elevation Myocardial infarction in Army Cardiac Centre. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Army Cardiac Centre, Lahore, from Jan 2020 to Mar 2020. Methodology: All patients undergoing primary percutaneous coronary intervention via transradial approach for acute ST elevation Myocardial infarction were included. Informed consent was taken signed. Demographic characteristics, risk factors, time variables like arterial access time, door to balloon time and procedural success was determined. Results: Out of enrolled patients in study, frequency of males and females were 49 (82%) and 9 (18%) respectively. The mean age was 57 ± 10.86 years ranging from 30 to 75 years. On admission, 25 (50%) were hypertensives, 20 (40%) had diabetes and 18 (36%) were smokers. The initial choice for primary percutaneous coronary intervention was transradial approach in all patients, right side 49 (98%) and left side 1 (2%). Due to failure to achieve radial access transfemoral and homolateral ulnar approach was adopted 2 (4%) and 1 (2%) respectively leading to 96% success and 4% failure for transradial access. The main infarcted artery was LAD 31 (62%) followed RCA 15 (30%) Time to arterial access time was 2 mins, door to balloon 34 mins. Eighty percent complication free transradial approach was achieved, 8 (16%) patients had pain and 2 (4%) developed hematoma. Conclusion: Our results proved Transradial approach for primary PCI as a safe, feasible and cost effective procedure.