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Background: Timely PCI following ACS has been shown to improve cardiovascular outcomes Most provincial hospitals in New Zealand are not PCI capable with consequent delays in transfer and revascularisation We compared post ACS outcomes in two similar size peripheral centers with and without on-site PCI availability Method: Retrospective data was collected for patients presenting with ACS to Hawke\'s Bay (HB) and PCI-capable Nelson & Marlborough (NM) DHBs between February 2017 - January 2018 Access to intervention and outcomes were analysed Logistic regression was used to evaluate confounding variables Results: There was no significant difference in mean age (68±3 6 vs 70±3 3) and GRACE scores (116±9 5 vs 124±8 6) between HB (n=249) and NM (n=256) HB had less intervention (55% vs 63%) with lower angiography-guided medical management (11% vs 21%) and longer door-to-intervention time (5 7±2 5 vs 1 2±0 48) compared to NM (p <0 001) HB also had higher 18-month MACCE (24% vs 19%) and mortality (16% vs 11%), which remained statistically significant following adjustment by logistic regression analysis [Formula presented] Conclusion: On-site PCI availability improves timely access to intervention and significantly reduces 18-month MACCE and mortality
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Heart_Lung_and_Circulation
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Long-Term Follow up of Patients Presenting With Acute Coronary Syndrome (ACS) in Two Peripheral Centers: The Implications of On-site Percutaneous Intervention (PCI) Access
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