ACUTE ST ELEVATION MYOCARDIAL INFARCTION

Abstract

Objective: To determine the frequency of in-hospital outcomes in patients ofacute ST elevation myocardial infarction (STEMI) within five days of hospitalization with .70ST segment resolution 90 minutes post thrombolysis. Study Design: Case series. Place andDuration of Study: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad,from April, 2016 to October, 2016. Methodology: In 370 patients fulfilling the inclusion andexclusion criteria a baseline 12 lead electrocardiogram was recorded before initiation ofthrombolysis and at 90 minutes thereafter. Conventional contraindications to thrombolysis wereobserved and streptokinase 1.5 mu was administered by intravenous infusion over 60 minutes.Successful thrombolysis was taken as 70% or more ST elevation resolution at 90 minutes frombaseline electrocardiogram measured 80ms from J-point. Patients with successful thrombolysiswere observed for in-hospital clinical outcomes of recurrent angina, congestive cardiac failure,ventricular arrhythmia and death within five days of hospitalization. Results: Out of 370 cases,51.35 %( n=190) were male while 48.65 %( n=180) were female, 25.14 %( n=93) were between30-50 years of age while 74.86 %( n=277) were between 51-65 years of age, the mean agewas 54.98+5.96 years. Frequency of in-hospital outcome was recorded as 10.67 %( n=38) forcongestive cardiac failure, 14.59 %( n=54) for ventricular arrhythmia, 5.40 %( n=20) for mortalitywhile no case had recurrent angina. Conclusion: In-hospital outcome is better in patients of.70% ST resolution at 90 minutes post thrombolysis .This might assist in identification of lowrisk patients who can be discharged early and should not be considered for early invasivestrategy.