A cross sectional study on thrombolysis in ST elevation myocardial infarction and its assessment with respect to ST segment resolution and time delay

Abstract

Background: ST elevation myocardial infarction is a leading cause of death in India. Several socio-economic factors lead to delay in seeking thrombolysis. Aims and Objectives: To analyse the effect of time delay on the success of thrombolysis. To study the influence of the anatomical location and risk factors like diabetes mellitus, hypertension, dyslipidemia, and smoking on the success of thrombolysis. Materials and Methods: It was a cross-sectional study conducted at Shifaa Hospital, Bangalore, over 12 months among 100 patients. The time delay in initiation of thrombolysis was recorded. Post thrombolysis ECG was compared for ST segment resolution. Results: The mean delay in thrombolysis was 12.1 hours, with an overall success rate of 51%. The success rates in patients with time delay of less than 3 hours, 3-6 hours, 6–12 hours, and more than 12 hours were 93.1%, 92.3%, 55.6%, and 5%, respectively (p value 0.0001). We found that 58.6% of patients with DM (p value 0.02) and 62.5% of patients with HTN (p value 0.009) had failed thrombolysis. Conclusions: Earlier initiation of thrombolysis increases the success rate of thrombolysis. Diabetes mellitus and hypertension lead to significant failure of thrombolysis.

Keywords

• stemi
• ecg criteria
• time delay
• streptokinase