Outcomes of Primary percutaneous coronary intervention Across Three Distinct Clinical Settings: A Single Operator’s Clinical Journey

Open Access

Abstract

Background: Global disparities in evidence-based care continue to exist. In ST-elevation myocardial infarction (STEMI), primary PCI is the favored approach, yet results differ due to patient characteristics, delays, hospital capabilities, and operator skill. In Bangladesh, PCI achievements are significant, but results vary, particularly among high-risk patients and in cases with system delays. This research examines PCI outcomes in three environments under one operator, concentrating on procedural effectiveness and in-hospital outcomes. Methods & Materials: This retrospective analysis encompassed 500 adult STEMI patients who received primary PCI from a singular operator at three centers in Bangladesh (2010–2026). Information on clinical and procedural factors was gathered from records. The main result was mortality during hospitalization. The analysis employed SPSS along with suitable statistical tests, and ethical approval was acquired. Results: In this study of 500 STEMI patients (n = 100, 200, 200), baseline features were comparable (p > 0.05) with the exception of smoking (p < 0.05), and approximately 60% had single-vessel disease. Pre-dilatation showed variability (~50.8%, p < 0.05), whereas other procedural aspects were similar. In-hospital mortality was minimal (3.2%) with no difference among centres (p > 0.05). Univariate analysis revealed no notable associations, whereas multivariate regression found diabetes to be the sole independent predictor (AOR ≈ 0.306, 95% CI: 0.105–0.889, p < 0.05). The clinical environment showed no considerable impact (AOR ≈ 1). Conclusion: Primary PCI demonstrated comparable results in all centers, exhibiting low mortality rates and no significant differences. Diabetes was the sole negative predictor, whereas the hospital environment had no effect.