Material and Method: Thailand national PCI registry enrolled 4,156 patients who underwent PCI from the all catheterization laboratories in Thailand between May 1st and October 31st, 2006.

Results: 581 patients with acute myocardial infarction (AMI), 352 patients underwent primary angioplasty, 229 patients underwent rescue angioplasty/facilitated PCI or after successful thrombolytic. Median FMC to device time in primary angioplasty group was 115 minutes (range 24-1335 minutes); only 29.8% of patients who able to achieve FMC to device time ≤90 minutes. Cardiogenic shock was significant lower if FMC to device time ≤90 minutes (2.1% (1/48) versus 12.4% (14/113) if FMC to device time >90, p = 0.040). In-hospital mortality occurred for 4.8% (2/48) if FMC to device time ≤90 minutes and was 8.8% (10/113) if FMC to device time >90 minutes, p = 0.510). Death occurred in 4.2% (2/48) if FMC to device time ≤90 minutes, 6.3% (5/79) if FMC to device time between 91-180 minutes, 6.7% (1/15) if FMC to device time between 181-270 minutes, 42.9% (3/7) if FMC to device time between 271-360 minutes and 8.3% (1/12) if FMC to device time >360 minutes, (p = 0.040).

Conclusion: FMC to device time is strongly associated with the risk of cardiogenic shock and mortality. In Thailand national PCI registry in 2006, the majority of the patients did not receive primary PCI in timely fashion.

Keywords: First medical contact to device time, Door to balloon time, ST elevation myocardial infarction (STEMI), Mortality