The Inpatient Outcome of Thrombolysis for an Acute St-Elevation Myocardial Infarction in the Coronary Care Unit of Ayub Teaching Hospital

Abstract

OBJECTIVES

This study aimed to determine the outcomes, clinical sequelae, and clinical characteristics of patients with pharmacological thrombolysis (lytic therapy) after acute ST-elevated myocardial infarction.

METHODOLOGY

This prospective cohort study was conducted in the Department of Interventional Cardiology from July 2022 to February 2025. The outcome of patients presenting with ST-elevated MI was stratified into successful thrombolysis and failed thrombolysis based on ECG and symptoms, which will be assessed after 2 hours of a Standard dose of Streptokinase. In both arms of the study, complications, sentinel events, hospital stay, and outcome were recorded. The coronary catheterization and 2-D echo findings will also be recorded. The data will be analyzed using SPSS version 21, and a p-value < 0.05 will be considered statistically significant.

RESULTS
Out of 1050 patients, a total of 779 individuals were included in the current study. The mean age of the studied cohort was 61 ± 9 years. We observed failed thrombolysis in 28% (215) of patients. On 2D echo, the most common hypokinetic wall was the inferior wall in both groups, and the difference was significant (p = 0.00). The frequencies of AKI, shock, and TPM in failed thrombolysis were 46%, 33%, and 5%, respectively, which were significantly higher than in the successful thrombolysis group. The LAD was the most common stenotic artery, and the difference was non-significant (p = 0.12). The SVCAD rate was 2% in the successful thrombolysis group and 6.5% in the failed thrombolysis group, with a significant difference (p = 0.00).  

CONCLUSION

The success rate of thrombolysis was significantly poor in diabetic, hypertensive, ischemic heart disease, and dyslipidemia patients. The NIV use and ICU admission were high in patients with successful thrombolysis.