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Title: Evolution of treatment for patients with acute myocardial infarction : a single centre experience of thrombolysis with rescue angioplasty moving to a comprehensive primary angioplasty service
Author: Kunadian, Babu
ISNI:       0000 0004 2738 8551
Awarding Body: University of Newcastle Upon Tyne
Current Institution: University of Newcastle upon Tyne
Date of Award: 2012
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Early restoration of infarct-related artery (IRA) blood flow and myocardial perfusion in patients with acute STEMI is associated with preservation of left ventricular function, myocardial salvage and reduction in mortality (GUSTO, 1993, FTT -Group, 1994, Berger et al., 1999, Cannon et al., 2000, De Luca et al., 2004, Shavelle et al., 2005, Brodie et al., 2006). Wider implementation of PPCI in the UK is limited by different geography and demography of the patients presenting with STEMI. There are difficulties in initiating a PPCI service and delivering therapy within recommended timelines. This has been due mainly to lack of facilities and trained staff, uncertainties about the cost-effectiveness of the strategy and difficulties in changing established practice. The widespread introduction of PPCI would have major implication for the reorganisation of health care provision. The primary aim of this thesis is the evaluation of a reorganisation of service from one based on thrombolysis (including a rescue angioplasty service) to a PPCI service at The lames Cook University Hospital for patients with acute myocardial infarction. The long-term outcomes of rescue PCI (rPCI), its use in high-risk groups, and an analysis of the predictors of failed rPCI procedures, form the basis of the first part of this thesis. Additional analysis reflects the change from one pathway of service delivery to another with the development of a PPCI service.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available