پزشکی بالینی ابن سینا (Mar 2020)
Study of the Duration, Outcomes, and Related Factors of Reperfusion Therapy in Patients with ST-Segment Elevation Myocardial Infarction
Abstract
Background and Objective: One of the most important advancements regarding the care of patients with acute myocardial infarction is the administration of anti-coagulation medicines (e.g., streptokinase). However, it must be noticed that this medicine requires rapid and timely administration. Moreover, Percutaneous Coronary Intervention (PCI) is increasingly used as a method of revascularization. Considering the importance of time for the effective use of these methods, the present study aimed to investigate the duration of the process, treatment outcome, and its associated factors in patients with ST-segment elevation myocardial infarction (STEMI) who were candidates for streptokinase or PCI. Materials and Methods: The present descriptive-analytical study made use of total population sampling so that all patients with STEMI who did not meet the exclusion criteria were included in the study in 2017. The study population consisted of 183 patients who had referred to the emergency ward of Tohid Hospital in Sanandaj, Iran. The patients were investigated regarding their age, gender, day of admission, pain-to-admission time, the average travel time to the hospital, type of referral, underlying illness, time of myocardial infarction diagnosis, starting time of reperfusion therapy, and final outcome. The collected data were recorded in the designed forms and then entered into SPSS software (version 22). Descriptive statistics formulas (i.e., mean, standard deviation, and percentage) were used regarding research questions. Moreover, regarding the research hypotheses, the chi-square test and correlation coefficients were used in the case of qualitative and quantitative variables, respectively. Results: According to the results, the majority of patients were male patients over 50 years old with no history of myocardial infarction. A total of 146 (79.8%) and 37 (20.2%) of participants were male and female, respectively. Moreover, the mean age of the participants was 58.52 and 28 of them (15.3%) had a history of myocardial infarction. The mean duration time of ECG and myocardial infarction diagnosis was 4.2 and 18.85 min, respectively. Furthermore, the mean duration time from patient admission to receiving intervention was estimated at 107.68 min. It should also be mentioned that their average length of hospital stay was 4.9 days. Conclusion: Based on the results, it can be said that the mortality rate was higher in older patients than in others. Moreover, the duration of ECG in female patients was longer in comparison to the male patients. In addition, starting the reperfusion therapy took longer in the night shifts.
