Results of Treatment of ST Elevation Myocardial Infarction (STEMI) Patients in Chaiyaphum Hospital

Abstract

ST elevation myocardial infarction (STEMI) is a disease with a high mortality rate. However, prompt appropriate treatment within the golden period can reduce the mortality rate. This descriptive study is aimed to evaluate the results of thrombolytic treatment for patients with STEMI in Chaiyaphum Hospital during the period 1 October 2010-30 September 2013. Of 276 patients with STEMI, 187 were given thrombolytic agent (67.0 %). The mean age was 66.9 years. There were males of 66.8 %, and 27.5 % with underlying diabetes, 38.9 % with hypertension, 21.0 % with dyslipidemia, and 37.1 % with smoking. All patients were treated with aspirin on admission, 21.1 % with beta blocker, 28.3 % with ACEI/ARB, 81.4 % with statins, 82.1% with clopidogrel, and 58.8 % with low molecular weight heparin. The mean waiting time interval for administration of thrombolytic agent was 62.1 minutes which was shorter than that of the studies from Taphanhin Hospital and Thai ACS Registry. Mean total time interval from first chest pain to thrombolytic agent administration was 329.3 minutes which was longer than that of the studies from Taphanhin, Chonburi Hospital, GRACE Studies, and Thai ACS Registry. There were 28.0 % of patients having cardiogenic shock and 56.6 % were referred to higher level hospital where CAG were available. Total mortality rate was 6.4 % which was closely similar to 5.3 % in the Thai ACS Registry.

To educate the people and the risk group about STEMI, to easily access the medical service, to call 1669 for the thrombolysis in time, and to have an effective team and referral system are important for achieving the goal of STEMI therapy. Furthermore, Maharat Nakhon Ratchasima Hospital, as the available referral center and to facilitate the community hospitals to conduct the thrombolytic treatment will also shorten the time interval to thrombolysis.