[Experience in the treatment of patients with STEMI in the frame of urgent PCI Project in Medimurje County].Acta Med Croatica. 2009 Feb; 63(1):103-4.AM
In 2004, the mortality rate of cardiovascular disease in Medimurje County was 53%, with coronary heart disease accounting for 18.2% of cases. The need of organizing a County team for health was recognized. Five health priorities were acknowledged with coronary heart disease on the top of the list. In 2005, Medimurje County was among the first regions outside Zagreb that had launched the Project of urgent percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients. Internal medicine physicians from the County Hospital received thorough education and printed materials on the issue were distributed to primary care physicians. A media campaign for the general population of the Medimurje County was also prepared. During the first 2 years of the project, the average pain-to-needle time in our patients was less than 4 hours. From the beginning of the project till July 2007, more than 100 patients with STEMI were treated with emergency PCI. There still are issues that have remained unsolved (how to reduce the pain-to-door and door-to-needle time, managing patients in cardiogenic shock, NSTEMI-patients, and presentation of patients with multivessel disease to cardiac surgeons). It is important to carry on with the intensive media campaign as well as with further education of patients, physicians and other health personnel.