Primary coronary angioplasty versus intravenous thrombolysis for acute myocardial infarction : a comparative study at queen alia heart institute

Abstract EN

Objectives: To assess the results of primary coronary angioplasty in comparison to thrombolytic therapy for the treatment of patients with acute myocardial infarction, and to compare the time from arrival of a patient with acute myocardial infarction at the coronary care unit of Queen Alia Heart Institute to having reperfusion therapy.

Methods: This is a retrospective study looking at consecutive reperfusion eligible patients with acute myocardial infarction who were treated (according to their physician's discretion) with either primary angioplasty or thrombolysis at Queen Alia Heart Institute between November 2002 and July 2005.

Data regarding patients' demographic characteristics, door to reperfusion time, risk factors for coronary artery disease, hospital stay, in-hospital mortality and various complications were collected.

Results: We had a total of 277 reperfusion eligible patients, including 143 who had primary angioplasty and 134 had thrombolysis.

The mean age of our population was 57.9 years.

Eighty percent of them were males.

Sixty six percent were smokers.

The prevalence of diabetes and hypertension were 39% and 41% respectively.

The mean hospital stay in the primary angioplasty group was 3.9 (SD±2.1) days compared to 6.6 (±SD 3.4) days in the thrombolysis group (P < 0.001).

Primary angioplasty was associated with a statistically significant lower in-hospital mortality (2%) compared with 8.5% in the thrombolysis group (P = 0.01).

There was no statistical significant difference in the incidence of reinfarction between the thrombolysis groups (1.9%) versus the angioplasty group (2.0%) (acute stent thrombosis) (P > 0.50).

The mean time from arrival to the emergency room to first balloon inflation of the infarct related artery was 63 minutes compared to 42 minutes door to needle time in the thrombolysis group.

Conclusions: Our data showed that primary coronary intervention for patients presenting with acute myocardial infarction at our centre has a favorable outcome with lower in-hospital mortality and a shorter hospital stay compared to thrombolysis.