Myocardial infarction: PCI rates

  • NICE indicator
  • IND74
  • Published:
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Indicator

The time between call for help and balloon inflation for patients with ST segment elevation myocardial infarction (STEMI) undergoing reperfusion by primary percutaneous coronary intervention (PCI).

Indicator type

Network / system level indicator.

The indicator would be appropriate to understand and report on the performance of networks or systems of providers.

This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.

To find out how to use indicators and how we develop them, see our NICE indicator process guide.

Rationale

All patients with ST-segment elevation myocardial infarction (STEMI) presenting 12 hours or less after onset of symptoms should undergo coronary reperfusion therapy. Heart muscle starts to be lost once a coronary artery is blocked and the sooner reperfusion therapy is delivered the better the outcome for the patient. Coronary angiography with follow-on primary PCI is the preferred reperfusion strategy for people with STEMI if it can be delivered within 120 minutes of the time when fibrinolysis could have been given. The National Audit of Percutaneous Coronary Intervention (2020) includes a standard that 75% of all patients should have a call to balloon time of less than 150 minutes.

Source guidance

Acute coronary syndromes. NICE guideline NG185 (2020), recommendation 1.1.3

Specification

Median time between call for help and balloon inflation for patients with STEMI undergoing reperfusion with primary PCI.

The Percutaneous coronary interventions (PCI) dataset defines call for help as the time of the initial call by the patient, relative or attendant (field number 5.27 and 5.29).

  • This may be to a GP, NHS Direct or the ambulance service.

  • If the patient self presents to accident and emergency this time should be arrival at first hospital.

  • If a patient is already in hospital or en route at the time they develop STEMI, this should be the time of the diagnostic ECG.

Exclusions:

The Percutaneous coronary interventions (PCI) dataset details the following exclusions:

  • Patients presenting in cardiogenic shock.

  • Patients requiring pre-PCI ventilation.

Data source: Percutaneous coronary interventions (PCI) dataset.

Minimum population: The indicator would be appropriate to understand and report on the performance of networks or systems of providers.

ISBN: 978-1-4731-5564-0