Primary angioplasty in Northern Galicia: care changes and results following implementation of the PROGALIAM protocol.

Abstract Introduction and objectives To analyze changes in healthcare delivery and results for primary angioplasty at Centro Hospitalario Universitario A Coruna following implementation of the PROGALIAM protocol. Methods Observational registry of 1434 patients referred for primary angioplasty between 2003 and 2007. Results under PROGALIAM (May 2005 – December 2007; n=963) were compared with those from the preceding period (January 2003 – April 2005; n=388). Results After implementing PROGALIAM, there were increases in the number of primary angioplasty procedures (preceding period, 14.4 cases/month; PROGALIAM, 32.2 cases/month), mean patient age (preceding period, 61.3 (11.9) years; PROGALIAM, 64.2 (11.7) years; P .001), and the percentage of patients referred from peripheral hospitals and treated after normal working hours. Overall median first medical contact-to-balloon time increased (previous period, 106 min; PROGALIAM, 113 min; P= .02), but decreased significantly among patients referred from noninterventional centers (previous period, 171 min; PROGALIAM, 146 min; P .001). Percentage of cases with an first medical contact-to-balloon time P= .56) and increased among patients at noninterventional centers, although it remained low in this subgroup (preceding period, 17%; PROGALIAM, 30%; P= .04). Thirty-day mortality (preceding period, 5.2%; PROGALIAM, 6.2%; P= .85) and 1-year mortality (preceding period, 9.5%; PROGALIAM, 10.2%; P= .96) remained unchanged. Conclusions Implementation of PROGALIAM allowed us to increase the percentage of patients receiving primary angioplasty without jeopardizing the clinical results of this treatment.