THROMBOLYTIC THERAPY SUCCESS RATE AND TIME TO THROMBOLYSIS IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION

Abstract

Objective: To determine the thrombolytic therapy success rate and time to thrombolysis in patients with ST-elevation Myocardial infarction (STEMI).

Material and methods: This descriptive cross-sectional study was conducted at the cardiology department of Khyber Teaching Hospital Peshawar. All patients with ST-elevation myocardial infarction 18 years and above presenting within twelve hours of symptom onset were enrolled. ECGs done before and 90 minutes after the administration of thrombolytic therapy were analyzed for ST-segment resolution (STR). The time of chest pain onset, the time to seek medical advice, and the start of thrombolytic therapy were recorded in addition to other information. Thrombolytic therapy was labeled Successful if there was STR of 50% and above with relief of chest pain. All the data was analyzed using SPSS software.

Results: The total study population was 168 with a mean age of 57.67 ±11.99 years while the mean BMI was 26.3± 4.5. The mean time to thrombolytic therapy was 5.96±4.1 hours.  Door-to-needle time in minutes was 33.8± 9.77. There were 66% (n=107) males while 34% (n=55) patients were females.  Overall Thrombolytic success rate was 69.1% (n=112). Those thrombolysed within 6 hours of symptoms onset showed a higher success rate than those receiving Streptokinase late (p = 0.004). The age of the patient, gender, and cardiovascular risk factors did not affect thrombolytic success.

Conclusion. Thrombolytic therapy is an effective option for STEMI patients with a high success rate if administered earlier.