FACTORS RELATED TO POOR OUTCOMES IN ST - SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) PATIENTS RECEIVING TIMELY VERSUS DELAYED THERAPY
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Keywords
ST-segment elevation myocardial infarction, adults, diabetes, hypertension, smoking
Abstract
Background: Coronary artery disease is the leading cause of death worldwide. Quick diagnosis and treatment are critical for improving outcomes in acute coronary syndrome. In cases of ST-segment elevation myocardial infarction (STEMI), prompt reperfusion is crucial since it shortens the overall length of tissue ischemia. A 30-minute delay in reperfusion can lower life expectancy by approximately one year. Despite huge attempts to assure timely treatment for STEMI over the last few decades, one-third of STEMI patients still do not receive reperfusion therapy on time.
Objective: To determine factors related to poor outcomes in STEMI patients receiving timely versus delayed therapy.
Study design: A comparative study
Place and Duration: This study was conducted in National Institutes of Cardiovascular Diseases Sukkur from February 2023 to February 2024
Methodology: It is assumed that severe adverse cardiac events occur in 22.9% of patients with early therapy (group A) and 42.9% of patients with delayed treatment (group B). About 200 patients were selected according to the selection criteria. All adult patients suspected of having a myocardial infarction (MI) underwent screening. To be eligible for the study, participants had to be between the ages of 18 and 65 years, male or female, and have a STEMI diagnosis.
Results: There were a total of 200 patients enrolled in this research. All of them were divided into 2 groups equally; Group A and Group B. There were 100 patients in each group. There were a total of 150 men and 50 women enrolled in this study. Of the total cases, 95 (47.5%) had diabetes, 60 (30.0%) smoked, and 91 (45.5%) were hypertensive. In group A worst socioeconomic status was present in 20% of cases, 50% cases were from rural areas, 9% had delayed response in emergency room, while 12% cases had history of chronic stable angina. Furthermore in group B worst socioeconomic status was present in 65% of cases, 47% cases were from rural areas, 20% had delayed response in emergency room, while 33% cases had history of chronic stable angina.
Conclusion: STEMI delays in presentation and treatment are frequently attributed to measurable reasons. This leads to lengthier hospital stays and a higher risk of in-hospital complications such re-infarction, acute heart failure, ventricular fibrillation, and mortality.
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Muhammad Hashim kalwar
Associate Professor adult Cardiology Adult, National Institutes of Cardiovascular Diseases Sukkur Pakistan.
Sarfraz Hussain Sahito
Assistant Professor adult Cardiology, National Institutes of Cardiovascular Diseases Khairpur Mirs Pakistan.
Mahwish Abbas
36 bedded UHC Malir Govt of Sindh Karachi Pakistan.
Ravi Raja
General Practitioner, MBBS, MD, NMC Specialty Hospital, Alain, Abu Dhabi, UAE.
Jaghat Ram
Assistant Professor Interventional Cardiology, National Institutes of Cardiovascular Diseases Larkana Pakistan.
Ghulam Abbas Shaikh
Gh Assistant Professor Interventional Cardiology, Civil Hospital Dow University Karachi Pakistan.