ACUTE ST ELEVATION MYOCARDIAL INFARCTION

70 % OR MORE ST SEGMENT RESOLUTION ON 90 MINUTES POST THROMBOLYSIS ELECTROCARDIOGRAM AS A PREDICTOR OF INHOSPITAL OUTCOMES

Abstract

Objective: To determine the frequency of in-hospital outcomes in patients of
acute ST elevation myocardial infarction (STEMI) within five days of hospitalization with .70
ST segment resolution 90 minutes post thrombolysis. Study Design: Case series. Place and
Duration of Study: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad,
from April, 2016 to October, 2016. Methodology: In 370 patients fulfilling the inclusion and
exclusion criteria a baseline 12 lead electrocardiogram was recorded before initiation of
thrombolysis and at 90 minutes thereafter. Conventional contraindications to thrombolysis were
observed and streptokinase 1.5 mu was administered by intravenous infusion over 60 minutes.
Successful thrombolysis was taken as 70% or more ST elevation resolution at 90 minutes from
baseline electrocardiogram measured 80ms from J-point. Patients with successful thrombolysis
were observed for in-hospital clinical outcomes of recurrent angina, congestive cardiac failure,
ventricular arrhythmia and death within five days of hospitalization. Results: Out of 370 cases,
51.35 %( n=190) were male while 48.65 %( n=180) were female, 25.14 %( n=93) were between
30-50 years of age while 74.86 %( n=277) were between 51-65 years of age, the mean age
was 54.98+5.96 years. Frequency of in-hospital outcome was recorded as 10.67 %( n=38) for
congestive cardiac failure, 14.59 %( n=54) for ventricular arrhythmia, 5.40 %( n=20) for mortality
while no case had recurrent angina. Conclusion: In-hospital outcome is better in patients of
.70% ST resolution at 90 minutes post thrombolysis .This might assist in identification of low
risk patients who can be discharged early and should not be considered for early invasive
strategy.