Barriers To The Implementation Of Primary PCI In The Management Of STEMI In Egypt

Abstract

Introduction: Evidence-based guidelines recommend Primary percutaneous coronary intervention (PPCI)
to be the mainstay reperfusion strategy for the treatment of STEMI if performed in the proper time window.
However, Egypt health care system is still struggling to provide such important service. The aim of the
present study, through a quantitative questionnaire, is to explore the current practice of management of
STEMI patients in Egypt, and to identify the barriers, opportunities, and potential areas of improvement.
Methods and Results: The questionnaire was conducted in Egypt via face to face qualitative in-depth
interviews with cardiologists from 14 PPCI-capable hospitals and 26 non-PPCI-capable hospitals.
Participants were selected in view of their experience and knowledge. The study identified potential
barriers to the implementation of PPCI among STEMI patients in Egypt. These barriers include among
others: the pre-hospital patient and EMS delay, delay in emergency department and patient transfer to
CCU, unavailable equipment, Cath lab activation delay, lack of trained interventional cardiologists, lack of
regional STEMI networks and hospital policies and insufficient ICU beds.
Conclusion: Limited resources and health care system inadequacies have led to potential barriers that
prevent suboptimal implementation of PPCI in Egypt. Efforts from all healthcare providers should be
directed to overcome these identified barriers.