THE SCOPE OF THROMBOLYTIC THERAPY AMONG ST SEGMENT ELEVATION MYOCARDIAL INFARCTION IN MISURATA CENTRAL HOSPITAL

Abstract

Little is known about thrombolytic therapy patterns in patients with ST-elevation myocardial infarction (STEMI) in
Libya. The objective of this study is to analyze the use of thrombolytic therapy in patients with ST-Elevation Myocardial Infarction (STEMI) in Misurata Central Hospital. The study includes 73 patients diagnosed with STEMI,
from hospital admission to discharge, from a total of 125 patients with acute myocardial infraction admitted to
Misurata Central Hospital cardiology care unit between January and December of 2009. RESULTS of the 73 patients
with STEMI, 52% (n=38) were thrombolysed with Streptokinase, Alteplase, and Tenecteplase. 14% of eligible
STEMI patients did not receive reperfusion therapy. The age of patients varied from 31 to 80 years of age, with a
median age of 55.9 years, a majority of 84% being male. The overall median symptom onset- to hospital presentation was 4 hours in thrombolytic recipient patients and 20 hours in non recipient patients. The median door to needle
time was 34 minutes. Poor left ventricular ejection fraction was less than 30% and reported more in nonthrombolytic recipient patients. Thrombolytic recipient patients were less likely to develop left ventricular failure.
The global in-hospital mortality rate for STEMI patients in 2009 was 8%. Thrombolytic therapy is the only form of
reperfusion strategy in Misurata. There was inappropriately long symptom-onset to hospital presentation as well as
door- to needle times. Thrombolytic agents improve morbidity but early mortality was relatively high, which needs
further exploration.