ABSTRACT
Acute myocardial infarction is one of the major causes of mortality in developing countries such as Iran. One of the most important progresses in acute myocardial infarction is early administration of thrombolytic agents such as streptokinase. This study was performed to determine the time interval from patients' referral to the emergency wards to the introduction of thrombolytic therapy and the factors associated with delay in drug administration. In a period of 8 months, 130 patients with presumed acute myocardial infarction were investigated. In order to determine the causes of delay in streptokinase administration, duration of symptoms onset to drug administration was divided into 4 specified periods and measured in minutes. Results were analyzed using ANOVA and t-test. Findings showed a mean elapsed time of 298 minutes between pain onset and referring to the emergency ward, 73 minutes between patient's arrival and streptokinase administration. Mean time from symptom onset to drug infusion was 370 minutes. There was a delay of 2 hours in drug administration in 18% of patients. The most important causes of delay were long distance and delay of physicians and staff. Considering the findings, increasing people's knowledge about the symptoms of heart problem, providing medical facilities and instruction of medical staff play important role in decreasing delay time in drug administration and increasing streptokinase output