0373 : Thrombolysis of myocardial infarction with ST segment elevation: Moroccan experience of Military Hospital of Instruction Mohammed V

Abstract

Management of STEMI is based on early myocardial revascularization alone guarantees a better prognosis of patents. The aim of our study was to evaluate the management of patients with STEMI undergoing intra-hospital thrombolysis in a center where the thrombolysis is made by cardiologist while the first contact with the patients is done by the emergency doctor. Prospective study conducted over a period of 2 years including 55 patients with undergoing intra-hospital thrombolysis, clinical and therapeutic patient’s data and the results of coronary angiography were collected and analyzed, our results were compared to those in the literature. The mean age of patients was 59.5 ± 13.69 years with a sex ratio M / F = 3, smoking and diabetes have been at the forefront of cardiovascular risk factors, 67% of patients arrived to the hospital on their own, and 33% by ambulance. The average time of presentation of patients to the emergency room from the beginning of the pain was 3.2h [45 min-8h], the average arrival to the emergency / thrombolysis was 40 minutes [10- 90 min]. Coronary angiography was performed within an average of 25H [2-75 H] after thrombolysis. Success judged on clinical and electrical criteria was achieved in 75% of cases, 15% of patients had clinical succees with the coronary flow TIMI less than 2. 52% of patients had single-vessel lesion, 27% double-vessel and 21% tri-vessel or left main artery disease. Rescue angioplasty was performed in 18% of patients. The total number of stent used was 72 (1.3 stent / patient. 11% of patients underwent surgery, and 2 patients died during the hospitalization. The management of STEMI in our climate still suffers from a delay attributable to patient consultation delay but also a significant delay between first medical contact and pharmacological revascularization, all public health policy efforts should be deployed to reduce this delay which affects the prognosis of patients.