Association between Time to Thrombolysis and Left Ventricular Systolic Function in Patients with St-Elevation Myocardial Infarction: Unraveling the Relationship

Authors

  • Zia Ullah Khan Ayub Teaching Hospital, Abbottabad
  • Nadia Haleem Ayub Medical College, Abbottabad
  • Rukhshanda Afsar Ayub Teaching Hospital, Abbottabad
  • Sania Saleem Ayub Teaching Hospital, Abbottabad
  • Saad Shams Ayub Teaching Hospital, Abbottabad
  • Wasif Ullah
  • Aftab Ahmad Ayub Teaching Hospital, Abbottabad

DOI:

https://doi.org/10.37762/jgmds.11-1.537

Keywords:

Myocardial infarction, Thrombolysis, Left Ventricular Systolic Function, ST-Elevation

Abstract

OBJECTIVES

To determine the association between time to thrombolysis and left ventricular (LV) systolic function in patients with ST-elevation Myocardial Infarction (STEMI).

METHODOLOGY

T This descriptive case series study compared the time to thrombolysis and LV systolic function of 149 STEMI patients. LV systolic function was evaluated following thrombolysis, and data were collected and analyzed using SPSS version 21.0 software. This study was conducted at the Ayub Teaching Hospital Cardiology Department in Abbottabad from August 2022 to January 2023.

RESULTS
The study examined how LV systolic function and symptoms in STEMI patients related to when thrombolysis was administered. The 149 patients analyzed included 28 with normal LV function, 86 with mildly impaired function, 26 with moderately impaired function, and 9 with severely impaired function. In contrast to delayed thrombolysis, which was linked to higher levels of impairment, immediate thrombolysis was correlated with a higher percentage of normal LV function. The prevalence of patients with severely compromised LV function was also higher in those who received thrombolysis within 3 to 6 hours and 9 to 12 hours. LV function was correlated with the type of myocardial infarction, with varying degrees of impairment seen in AWMI and IWMI patients. Gender had no discernible effect on LV function.

CONCLUSION

Improved LV function is associated with early thrombolysis within hours of STEMI symptoms, highlighting the significance of prompt intervention and minimizing wait times for better patient outcomes.

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Author Biographies

Zia Ullah Khan, Ayub Teaching Hospital, Abbottabad

PG Resident Cardiology Unit,
Ayub Teaching Hospital, Abbottabad

Nadia Haleem, Ayub Medical College, Abbottabad

Associate Professor,
Biochemistry Department,
Ayub Medical College, Abbottabad

Rukhshanda Afsar, Ayub Teaching Hospital, Abbottabad

PG Resident Cardiology Unit,
Ayub Teaching Hospital, Abbottabad

Sania Saleem, Ayub Teaching Hospital, Abbottabad

PG Resident
Cardiology Unit,
Ayub Teaching Hospital, Abbottabad

Saad Shams, Ayub Teaching Hospital, Abbottabad

PG Resident
Cardiology Unit,
Ayub Teaching Hospital, Abbottabad

Wasif Ullah

PG Resident
Cardiology Unit,
Ayub Teaching Hospital, Abbottabad

Aftab Ahmad, Ayub Teaching Hospital, Abbottabad

PG Resident
Cardiology Unit,
Ayub Teaching Hospital, Abbottabad

References

Scărlătescu AI, Barbălată T, Sima AV, Stancu C, Niculescu L Ștefan, Micheu MM. miR-146a-5p, miR-223-3p and miR-142-3p as Potential Predictors of Major Adverse Cardiac Events in Young Patients with Acute ST Elevation Myocardial Infarction-Added Value over Left Ventricular Myocardial Work Indices. Diagnostics (Basel, Switzerland). 2022 Aug 12;12(8):1946

Vogel B, Claessen BE, Arnold SV, Chan D, Cohen DJ, Giannitsis E, et al. ST-segment elevation myocardial infarction. Nature Reviews Disease Primers [Internet]. 2019 Jun 6;5(1)

Cha M-J, Kim H-S, Kim SH, Park J-H, Cho G-Y. Prognostic power of global 2D strain according to left ventricular ejection fraction in patients with ST elevation myocardial infarction. PloS one. 2017 Mar 23;12(3):e0174160–e0174160

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Kardiologia Polska. 2016 Oct 13;74(10):1037–147

ESC, Study Group. THE TASK FORCE FOR THE MANAGEMENT OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS PRESENTING WITH ST-SEGMENT ELEVATION OF THE EUROPEAN SOCIETY OF CARDIOLOGY (ESC) 2017 ESC GUIDELINES FOR THEMANAGEMENT OF ACUTEMYOCARDIAL INFARCTION IN PATIENTS PRESENTING WITH ST-SEGMENT ELEVATION. Russian Journal of Cardiology. 2018 Jun 2;(5):103–58

Neumann F-J, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. EuroIntervention. 2019 Feb;14(14):1435–534

Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. The Lancet. 2003 Jan;361(9351):13–20

Bendary A, Tawfik W, Mahrous M, Salem M. Fibrinolytic therapy in patients with ST-segment elevation myocardial infarction: Accelerated versus standard Streptokinase infusion regimen. Journal of cardiovascular and thoracic research. 2017;9(4):209–14

Siddiqui AJ, Holzmann MJ. Association between reduced left ventricular ejection fraction following non-ST-segment elevation myocardial infarction and long-term mortality in patients of advanced age. International Journal of Cardiology. 2019 Dec;296:15–20

Mor Khan Shar, Zahoor Ahmed Rana, Muhammad Naeem Malik, Hina Rehman, Amna Nisar, Rana Waleed Khan. Oral Hygiene and Periodontal Health Status of Acute Coronary Syndrome Patients reported in PIMS Islamabad. Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University. 2021 May 19;17(2):90–3

Frantz S, Hundertmark MJ, Schulz-Menger J, Bengel FM, Bauersachs J. Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies. European heart journal. 2022 Jul 14;43(27):2549–61

Covinhes A, Gallot L, Barrère C, Vincent A, Sportouch C, Piot C, et al. Anti-apoptotic peptide for long term cardioprotection in a mouse model of myocardial ischemia-reperfusion injury. Scientific reports. 2020 Oct 22;10(1):18116–18116

Prabhakaran AP, Anandan H. Outcome of Thrombolytic Therapy in Hypertensives with Acute Myocardial Infarction. International Journal of Contemporary Medical Research [IJCMR] [Internet]. 2018 May;5(5)

Danchin N, Puymirat E, Cayla G, Cottin Y, Coste P, Gilard M, et al. One-Year Survival After ST-Segment–Elevation Myocardial Infarction in Relation With Prehospital Administration of Dual Antiplatelet Therapy. Circulation: Cardiovascular Interventions [Internet]. 2018 Sep;11(9)

Ross AM, Coyne KS, Reiner JS, Greenhouse SW, Fink C, Frey A, et al. A randomized trial comparing primary angioplasty with a strategy of short-acting thrombolysis and immediate planned rescue angioplasty in acute myocardial infarction: the PACT trial. Journal of the American College of Cardiology. 1999 Dec;34(7):1954–62

Thiele H, Ohman EM, de Waha-Thiele S, Zeymer U, Desch S. Management of cardiogenic shock complicating myocardial infarction: an update 2019. European Heart Journal. 2019 Jul 4;40(32):2671–83

Hochman JS, Sleeper LA, Webb JG, Dzavik V, Buller CE, Aylward P, et al. Early revascularization and long-term survival in cardiogenic shock complicating acute myocardial infarction. JAMA. 2006 Jun 7;295(21):2511–5

Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Kardiologia Polska. 2018 Feb 16;76(2):229–313

O’Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary. Journal of the American College of Cardiology. 2013 Jan;61(4):485–510

Boersma E, Maas ACP, Deckers JW, Simoons ML. Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. The Lancet. 1996 Sep;348(9030):771–5

Baliga RR, Bahl VK, Alexander T, Mullasari A, Manga P, Dec GW, et al. Management of STEMI in Low- and Middle-Income Countries. Global Heart. 2014 Dec 1;9(4):469

De Luca L, Veneziano FA, Karaboue M. Late Presenters with ST-Elevation Myocardial Infarction: A Call to Action. Journal of clinical medicine. 2022 Sep 1;11(17):5169

Danchin N, Puymirat E, Steg PG, Goldstein P, Schiele F, Belle L, et al. Five-Year Survival in Patients With ST-Segment–Elevation Myocardial Infarction According to Modalities of Reperfusion Therapy. Circulation. 2014 Apr 22;129(16):1629–36

Gong W, Li A, Ai H, Shi H, Wang X, Nie S. Safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction: A meta-analysis of randomised controlled trials. European Journal of Preventive Cardiology. 2018 Mar 14;25(8):807–15

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Published

2023-12-31

How to Cite

Khan, Z. U., Haleem, N. ., Afsar, R. ., Saleem, S. ., Shams, S. ., Ullah, W. ., & Ahmad, A. (2023). Association between Time to Thrombolysis and Left Ventricular Systolic Function in Patients with St-Elevation Myocardial Infarction: Unraveling the Relationship. Journal of Gandhara Medical and Dental Science, 11(1), 13–16. https://doi.org/10.37762/jgmds.11-1.537