Efficacy in giving timely thrombolytic therapy in patients of acute myocardial infarction in Mayo Hospital, Lahore

ABSTRACT

This study was carried out in Mayo Hospital, Lahore to see the efficacy of administration of thrombolytic therapy within the target time of 30 minutes in patients with acute myocardial infaction [AMI]. For this purpose 52 patients with AMI eligible for thrombolysis were included, and timings were recorded for each step in administering streptokinase [SK]. 47 patients were male and 5 were female. Two peaks occurred at 42-50 years and 60-65 years of age. 30 [57.7 percent] patients had anterior wall MI and 22[43.2 percent] had inferior wall MI. On average times noted were ECG in 15.4 min, SK decided and relatives informed after 17.5 min, SK available in 51.6 min and infusion started in 12.8 min, and aggregate in-hospital delay was of 97.5 min. Only 20 [38.5 percent] patients had an ECG done in 10 min, and door-to-needle time of 30 min was achieved in only 5 [9.6 percent] patients. Factors including sex, education, arrival time, and known IHD were not statistically significant, except that those in lower socioeconomic groups took significantly longer to reach the hospital and then bringing SK. Hence it is important that hospitals should develop proper plans to identify and rapidly manage such patients in the emergency room. SK should also be available in the emergency department