Abstract
objectives: Acute myocardial infarction(AMI) is becoming increasingly important problem in developing countries, and thrombolysis is the main modality of treatment here. About 25-50% of patients fail to achieve successful reperfusion and these patients have poor prognosis. Since alternative modes of reperfusion are available, it is important to identify them. This study was aimed at defining the extent of failed thrombolysis and identifying its demographic and clinical predictorsMethods: 50 cases of thrombolysed AMI patients were studied. Failed thrombolysis considered if there is 0.05), percentage of females was 25% v/s 16.7%(P>0.05), mean time for resolution of chest pain was 3.55±1.1 hrs v/s. 1.98±0.93 hrs (P 0.05), inferior wall MI was 30% v/s 46% (P>0.05) in failed and successful group respectivly. Interpretation and conclusion.Late presentation is an important risk factor for failed thrombolysis in AMI. Persistence of chest pain and non-resolution of reciprocal ST depression are significantly associated with failed thrombolysis.
Highlights
Acute myocardial infarction is one of the most common diagnoses in hospitatised patients in industrialized countries.[1]
Risk factors for coronary heart disease: The percentage of patients with diabetes, hypertension and dyslipidemia was higher in failed thrombolysis group
Resolution of chest pain: The mean time for resolution of chest pain was higher in failed thrombolysis group (p 2hr after thrombolysis and it resolved in ≤ 2 hrs in 80% of patients with successful thrombolysis (p
Summary
Acute myocardial infarction is one of the most common diagnoses in hospitatised patients in industrialized countries.[1]. 60 to 70% of treated patients can be successfully reperfused, thrombolytic treatment fails in a substantial proportion. These non-responsive patients can have a significant high mortality and morbidity. Since alternative modes of coronary intervention are available, it is prudent to identify patients with failed thrombolysis so that they can be offered alternative modes of reperfusion.[4] The present study is aimed at defining the extent of failed thrombolysis and assessing its demographic and clinical predictors in our hospital. This study was aimed at defining the extent of failed thrombolysis and identifying its demographic and clinical predictors Methods: 50 cases of thrombolysed AMI patients were studied. Results: Of 50 patients studied 30(60%) achieved successful thrombolysis and 20(40%) failed. Persistence of chest pain and non-resolution of reciprocal ST depression are significantly associated with failed thrombolysis Keywords: acute myocardial infarction; streptokinase; ST segment resolution; failed thrombolysis; time to thrombolysis; predictors of failed thrombolysis
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