Clinical Presentation, Treatment, and In-hospital Outcomes of ST-Segment Elevation Myocardial Infarction: A North East Indian Study

Abstract

Background: India has a substantial burden of acute coronary syndromes, yet awareness regarding treatment and outcome of these conditions is limited. Thus, the present study aimed to document the characteristics, treatments, outcomes, and reasons for prehospital delay in patients with ST-segment elevation myocardial infarction (STEMI) admitted to a tertiary care hospital in North East India. Materials and Methods: A prospective, hospital-based, observational study was conducted at a tertiary care hospital in North East India between December 2016 and November 2017. All consecutive patients presenting with electrocardiographic evidence of STEMI were included in the study. Results: A total of 100 patients were assessed. Of these patients, 84 (84.0%) were male and 59 (59.0%) were urban residents. Smoking, hypertension, and dyslipidemia were the most common risk factors observed in 71 (71.0%), 55 (55.0%), and 43 (43.0%) patients, respectively. Anterior wall myocardial infarction was the most frequent type of STEMI observed in 59 (59.0%) patients. Only 54 (54.0%) patients reached the hospital within the window period. The average time to reach the hospital was 355 min. Thirty-three (33.0%) patients underwent thrombolysis, while 14 (14.0%) patients underwent primary percutaneous coronary intervention. Inhospital mortality occurred in 5 (5.0%) patients. Conclusion: Most patients were in the 60–69 years' age group, urban residents, and smokers. They received late medical care and received emergency therapies less often. In most cases, prehospital delay was due to patient inability to recognize symptoms at onset. Strategies to curb tobacco use, decrease prehospital delay, and improve urgent care could reduce morbidity and mortality in this patient subset.