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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe first percutaneous coronary intervention (PCI) was performed in the mid-1970s; however, PCI has been available in Guyana only since 2006. The Caribbean Heart Institute (CHI), a 5-bed inpatient facility with 1 catheterization lab, 1 resident cardiologist, 2 internists, and 12 nurses, was the first center in Guyana to perform PCI. This article presents results of a case series that assessed the clinical outcomes of all cases in whom percutaneous transluminal coronary angioplasty or stenting was attempted between January 1, 2011, and June 30, 2013.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe first percutaneous coronary intervention (PCI) was performed in the mid-1970s; however, PCI has been available in Guyana only since 2006. The Caribbean Heart Institute (CHI), a 5-bed inpatient facility with 1 catheterization lab, 1 resident cardiologist, 2 internists, and 12 nurses, was the first center in Guyana to perform PCI. CHI receives referrals from a 215,000-km\u003Csup\u003E2\u003C\/sup\u003E area, which can potentially increase the time from symptom onset to revascularization.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EJoel Joseph, MD, CHI, Georgetown, Guyana, presented results of a case series that assessed the clinical outcomes of all cases in whom percutaneous transluminal coronary angioplasty (PTCA) or stenting was attempted between January 1, 2011, and June 30, 2013. The outcomes assessed included death (at hospitalization, and at 30 days and 6 months post revascularization), acute renal failure, arrhythmias, myocardial infarction (MI), blood transfusions, and access site hematomas. Vital status of cases treated with PCI was confirmed either by medical record review or by phone. Death was confirmed by entry into the National Death Registry and cause of death on the death certificate.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EFifty-eight cases (mean age 58 \u00b1 8 years; men\u2014women ratio, 3:1) received revascularization. The success rate of revascularization (defined as TIMI 3 flow + \u0026lt; 25% stenosis post procedure) was 97%. Most cases (61%) had their intervention within 1 day of presentation; 86% were discharged within 2 days of intervention.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EOne case died after discharge from the hospital. She was a 56-year-old woman with diabetes, hypertension, and congestive heart failure as well as a history of prior PCI (2 years prior). The case was discharged within a day of her intervention, with no documented complications, and she was given a prescription for antiplatelet medication. She died 16 days later after failing to comply with dual-antiplatelet therapy and developing acute stent thrombosis. Of the 58 cases treated, 10 had an arrhythmia, 6 had an MI, and 3 had an access site hematoma. Acute renal failure and blood transfusion were reported in 1 patient each (1.72%). All cases remaining in hospital for more than 7 days had complications (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/24\/16\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Complication Incidence Increased With Length of Hospital Stay\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-483053355\u0022 data-figure-caption=\u0022Complication Incidence Increased With Length of Hospital Stay\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/24\/16\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/24\/16\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/24\/16\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14788\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EComplication Incidence Increased With Length of Hospital Stay\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from J Joseph, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EPeriprocedural complications were numerically greater, albeit not statistically significant, in men, cases aged \u0026gt; 55 years at the time of intervention, and those undergoing PCI for a ST-segment elevation myocardial infarction. Similarly, cases with \u0026gt; 28 days between symptom onset and intervention and those requiring multivessel revascularization had more periprocedural complications, but these were also not significant.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThis study was limited in that it was a single-center observational study with no controls. There were few events, and it was difficult to confirm information from the records. Despite this, Dr. Joseph concluded that the success rates and outcomes of PCIs done at CHI were acceptable, especially considering the low volume of cases and the recent initiation of the PCI program.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/24\/16.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzovr2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzovr2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}