Changing trends of patients undergoing thrombolysis for acute ST-elevated myocardial infarction in tertiary care hospital in Maharashtra, India

Abstract

Background: Coronary artery disease (CAD) is becoming a major cause of morbidity and mortality burden in the developing world. Indians have been associated with a more severe form of CAD that has its onset at a younger age group with a male predominance. Reperfusion of the occluded coronary artery at the earliest is the most important aim of management of acute ST-elevation myocardial infarction (STEMI). Aim: The aims of this work were to (1) study the changing trends in patients presenting with STEMI, (2) the outcomes of patients undergoing thrombolysis in a tertiary care hospital, and (3) the increasing trend of CAD in young (CADY). Materials and Methods: A total of 500 patients undergoing thrombolysis between January 2017 and December 2019 were studied retrospectively. We studied the age of presentation, sex, agents used for thrombolysis, their angiography findings, and their management and outcome. Results: CADY in less than 45 years of age was noted in 26.2% in our study. It was more common in men. Left anterior descending coronary artery (LAD) was the most common artery to be involved in single-vessel coronary artery disease (SVCAD) patients followed by the right coronary artery (RCA). Door to needle time in our study was 28 min. Conclusion: The prevalence of CADY Indians in our study was significantly high. The most common age group of men presenting with STEMI was 51–55 years, followed by 45–50 years. The most common age group of women presenting with CAD was 61–65 years.