Delay of fibrinolysis in ST- elevation myocardial infarction: results of an investigation conducted in a single center in Sousse Tunisia

ABSTRACT

The aim of our study was to assess the delay of fibrinolysis in ST elevation myocardial infarction [STEMI] in our region and to identify characteristics associated with prolonged delay. We analyzed clinical characteristics of a prospective cohort of unselected patients admitted for [STEMI]. The study was conducted over three years 2007-2009 and 250 patients were included in a single center without capability of percutaneous coronary intervention. The mean age of our patients was 58 +/- 13, 7 years. Ninety percent of our patients consult directly the emergency department and 61, [5%] of them were admitted within first 6 hours of onset of symptoms. Median time to reperfusion was 46 min. Predictor of this long delay to initiate fibrinolysis were inter-department decision OR 6; 95% CI 3,48-10,34, diabetes OR 2,25; 95% CI 1,28-3,96 age >58,4 years OR 1,97; 95% CI 1,19-3,25 and transfer from regional hospital to our center OR 1,78; 95% 1,03-3.07. These results suggest that improvement in organization health care system can shorten delay to fibrinolysis in a center without percutaneous coronary intervention capability