How to implement Primary PCI in IRAN (Stent-Save a Life!)

Since Its introduction in the late 1970, primary coronary intervention (PCI) has been popularized around the world and become one of the main revascularization strategies for the treatment of acute myocardial infarction. Iran was one of the pioneer for starting PCI in the region and since its introduction, Iranian Interventionist gain a high level of technical performance. One of the latest achievements is the development of Iranian 247 Primary PCI Registry and, given the significance of primary PCI in saving the lives of patients with acute myocardial infarction and the need for a round- the-clock supply of such services, with the mutual participation of Iranian Ministry of Health, the project has been started in early 2015. The national scientific committee has followed three preliminary steps: a full scale scan of the current situation, estimating the basic requirements for the project and finally recognition of available resources. Ever since, this committee has held several sessions and compiled a national document regarding acute coronary events.since September 2015, the committee has been conducting a plan entitled the 24/7 plan in 31 primary PCI centers, which aims at providing primary PCI 24 hours a day, 7 days in a week.Of these 31 hospitals, 12 are heart hospitals and the rest are general hospitals.These centers were committed to performed primary PCI strategy as their main revascularization strategy. Alongside, several additional tasks like the establishment of primary PCI database, equipping the Emergency Mobile System have been taken. The first phase was a great achievement for Iranian Interventional Community and consequently the project has been expanded. In the present situation, 31 Primary PCI centers are active in 24/7 basis and more than 50 centers offer primary PCI services on a part-time basis and more than 25000 cases of primary PCI has been accomplished. Telemedicine is in its earliest phase, but hopefully the pilot was quite successful in Tehran. ECGs are taken in the ambulance and sent to the cardiologist resident in the Dispatch. If the Cardiologist diagnoses STEMI, the ambulance is directed to the nearest 24/7 primary PCI capable hospital. This hospital then immediately transfers the patient to the cath.lab without any delay in the emergency department. Finally, the project was the source of inspiration for various national projects which Thrombolysis for acute stroke patients were one of the most important one.