Hélder Pereira, Ana Rita Pereira, Rita Calé, Dejan Orlić, Rhena Delport, Sayfollah Abdi, Bagrat Alekyan, Khalid F Al Habib, Carolina Artucio, Ignacio Batista, Jorge Belardi, Alfonsina Candiello, Christos Christou, Leonardo De Luca, Andrejs Erglis, António Fiarresga, Habib Gamra, Martine Gilard, Wei-Chung Huang, John Kanakakis, Lukasz Koltowski, Michael Lee, Awad Mohamed, Ștefan Mot, Mzee Ngunga, Paul Ong, Patricio Ortiz, Oleg Polonetsky, Sameh Shaheen, Khaled Shokry, João Silveira, Mohamed Sobhy, Maxim Sokolov, Ibrahim Terzic, Ahmed Vachiat, Deniss Vasiljevs, William Wijns, Kyaw Win, Thomas Alexander, Jan Piek
{"title":"st段抬高型心肌梗死经皮冠状动脉介入治疗的世界范围内的程序差异：来自“支架-拯救生命”倡议的见解。","authors":"Hélder Pereira, Ana Rita Pereira, Rita Calé, Dejan Orlić, Rhena Delport, Sayfollah Abdi, Bagrat Alekyan, Khalid F Al Habib, Carolina Artucio, Ignacio Batista, Jorge Belardi, Alfonsina Candiello, Christos Christou, Leonardo De Luca, Andrejs Erglis, António Fiarresga, Habib Gamra, Martine Gilard, Wei-Chung Huang, John Kanakakis, Lukasz Koltowski, Michael Lee, Awad Mohamed, Ștefan Mot, Mzee Ngunga, Paul Ong, Patricio Ortiz, Oleg Polonetsky, Sameh Shaheen, Khaled Shokry, João Silveira, Mohamed Sobhy, Maxim Sokolov, Ibrahim Terzic, Ahmed Vachiat, Deniss Vasiljevs, William Wijns, Kyaw Win, Thomas Alexander, Jan Piek","doi":"10.1016/j.carrev.2025.07.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>ST-elevation myocardial infarction (STEMI) outcomes have improved through initiatives that promote timely access to primary percutaneous coronary intervention (PCI). However, little is known about how primary PCI is performed across different settings. This study proposes to characterize and compare practical aspects of primary PCI globally.</p><p><strong>Methods: </strong>An electronic survey, assessing thirteen aspects potentially affecting primary PCI timing and efficacy, was distributed to interventional cardiologists in the \"Stent-Save a Life!\" initiative. Comparisons were made based on geographical locations and annual PCI volume.</p><p><strong>Results: </strong>Seven hundred-and-twenty-four responses were received (59 % from Europe, 18 % from Latin America, 15 % from Asia, 9 % from Africa); 88 % of participants worked in high-volume primary PCI centers. African operators generally performed ≤75 primary PCIs annually, in contrast to their counterparts in Europe, Asia, and Latin America. Access route varied significantly across regions: radial access was used in 98 % of primary PCIs in Europe but only 53 % in Africa. Left ventriculography was more frequently performed in Latin America (25 %) and Africa (20 %) than in Europe (9 %) and Asia (6 %). Aspiration thrombectomy was performed under different conditions. Non-culprit lesion revascularization was typically completed during the index procedure or before discharge, except in Asia. Most participants from Europe (82 %) and Asia (85 %) reported pretreating their patients with P2Y<sub>12</sub> inhibitors. High-volume operators were more likely to work in 24/7 PCI hospitals, prefer radial access, and routinely perform thrombus aspirations and PCI on non-infarct-related arteries after discharge.</p><p><strong>Conclusions: </strong>This global survey identified procedural variations in performing primary PCI, indicating room for improvement, particularly in the African region.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Worldwide procedural variations of primary percutaneous coronary intervention for ST-elevation myocardial infarction: Insights from the \\\"Stent - Save a Life!\\\" initiative.\",\"authors\":\"Hélder Pereira, Ana Rita Pereira, Rita Calé, Dejan Orlić, Rhena Delport, Sayfollah Abdi, Bagrat Alekyan, Khalid F Al Habib, Carolina Artucio, Ignacio Batista, Jorge Belardi, Alfonsina Candiello, Christos Christou, Leonardo De Luca, Andrejs Erglis, António Fiarresga, Habib Gamra, Martine Gilard, Wei-Chung Huang, John Kanakakis, Lukasz Koltowski, Michael Lee, Awad Mohamed, Ștefan Mot, Mzee Ngunga, Paul Ong, Patricio Ortiz, Oleg Polonetsky, Sameh Shaheen, Khaled Shokry, João Silveira, Mohamed Sobhy, Maxim Sokolov, Ibrahim Terzic, Ahmed Vachiat, Deniss Vasiljevs, William Wijns, Kyaw Win, Thomas Alexander, Jan Piek\",\"doi\":\"10.1016/j.carrev.2025.07.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>ST-elevation myocardial infarction (STEMI) outcomes have improved through initiatives that promote timely access to primary percutaneous coronary intervention (PCI). However, little is known about how primary PCI is performed across different settings. This study proposes to characterize and compare practical aspects of primary PCI globally.</p><p><strong>Methods: </strong>An electronic survey, assessing thirteen aspects potentially affecting primary PCI timing and efficacy, was distributed to interventional cardiologists in the \\\"Stent-Save a Life!\\\" initiative. Comparisons were made based on geographical locations and annual PCI volume.</p><p><strong>Results: </strong>Seven hundred-and-twenty-four responses were received (59 % from Europe, 18 % from Latin America, 15 % from Asia, 9 % from Africa); 88 % of participants worked in high-volume primary PCI centers. African operators generally performed ≤75 primary PCIs annually, in contrast to their counterparts in Europe, Asia, and Latin America. Access route varied significantly across regions: radial access was used in 98 % of primary PCIs in Europe but only 53 % in Africa. Left ventriculography was more frequently performed in Latin America (25 %) and Africa (20 %) than in Europe (9 %) and Asia (6 %). Aspiration thrombectomy was performed under different conditions. Non-culprit lesion revascularization was typically completed during the index procedure or before discharge, except in Asia. Most participants from Europe (82 %) and Asia (85 %) reported pretreating their patients with P2Y<sub>12</sub> inhibitors. High-volume operators were more likely to work in 24/7 PCI hospitals, prefer radial access, and routinely perform thrombus aspirations and PCI on non-infarct-related arteries after discharge.</p><p><strong>Conclusions: </strong>This global survey identified procedural variations in performing primary PCI, indicating room for improvement, particularly in the African region.</p>\",\"PeriodicalId\":47657,\"journal\":{\"name\":\"Cardiovascular Revascularization Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-07-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Revascularization Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.carrev.2025.07.017\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Revascularization Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.carrev.2025.07.017","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Worldwide procedural variations of primary percutaneous coronary intervention for ST-elevation myocardial infarction: Insights from the "Stent - Save a Life!" initiative.
Background: ST-elevation myocardial infarction (STEMI) outcomes have improved through initiatives that promote timely access to primary percutaneous coronary intervention (PCI). However, little is known about how primary PCI is performed across different settings. This study proposes to characterize and compare practical aspects of primary PCI globally.
Methods: An electronic survey, assessing thirteen aspects potentially affecting primary PCI timing and efficacy, was distributed to interventional cardiologists in the "Stent-Save a Life!" initiative. Comparisons were made based on geographical locations and annual PCI volume.
Results: Seven hundred-and-twenty-four responses were received (59 % from Europe, 18 % from Latin America, 15 % from Asia, 9 % from Africa); 88 % of participants worked in high-volume primary PCI centers. African operators generally performed ≤75 primary PCIs annually, in contrast to their counterparts in Europe, Asia, and Latin America. Access route varied significantly across regions: radial access was used in 98 % of primary PCIs in Europe but only 53 % in Africa. Left ventriculography was more frequently performed in Latin America (25 %) and Africa (20 %) than in Europe (9 %) and Asia (6 %). Aspiration thrombectomy was performed under different conditions. Non-culprit lesion revascularization was typically completed during the index procedure or before discharge, except in Asia. Most participants from Europe (82 %) and Asia (85 %) reported pretreating their patients with P2Y12 inhibitors. High-volume operators were more likely to work in 24/7 PCI hospitals, prefer radial access, and routinely perform thrombus aspirations and PCI on non-infarct-related arteries after discharge.
Conclusions: This global survey identified procedural variations in performing primary PCI, indicating room for improvement, particularly in the African region.
期刊介绍：
Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.
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