Clinical and angiographic outcome following thrombolysis in acute ST-elevation myocardial infarction (STEMI)- comparison of patients thrombolysed and referred from peripheral hospitals versus those admitted directly in our hospital.

Abstract

BACKGROUND: Guidelines on myocardial revascularization emphasize the need to minimize reperfusion delay time for patients with AMI. Recently the primary care physicians of Kashmir valley have formed a WhatsApp group (Save Heart) in collaboration with two cardiologists of our institution.
OBJECTIVE: To evaluate the effect of early thrombolysis in the peripheral hospital versus our hospital
PARTICIPANTS: 205 STEMI patients who received thrombolysis.
STUDY DESIGN: Prospective Observational Study
METHODS: All STEMI patients who received thrombolysis either at the peripheral hospital or at our hospital were evaluated for clinical and angiographic parameters
RESULTS: In our study total of 205 patients were included out of the 142 (69.3%) patients who were thrombolysed at the peripheral hospital and 63 (30.7%) patients were thrombolysed at our hospital. The mean age was 57 years. 85% were male and 15% were female. 78.4% of patients were smokers, 63.5% patients were hypertensive and 17.7% patients were diabetic. At peripheral hospital streptokinase was the main thrombolytic agent (93.5%) while at our hospital majority of patients (43.3%) were thrombolysed with reteplase. In 53.57% of patients, Door-to-needle duration was <30 minutes. 90.25% of patients received thrombolysis within 12 hours of symptom onset in which the mean door-to-needle duration was 50.55±59.56 minutes and 78.98±84.02 minutes at the peripheral hospital and at our hospital respectively. (P<0.001)
CONCLUSION: Save Heart Initiative has played a significant role in early diagnosis and emergent treatment at a peripheral hospitals.