Assessment of initiation time of thrombolytic therapy in patients with st-segment elevation myocardial infarction in hamad general hospital

Abstract EN

The elevation of reperfusion therapy for acute ST- segment elevation myocardial infarction are time-related and there are decreasing benefits with increasing delays to therapy.

To determine whether the time interval between a patient's arrival at the emergency department of Hamad General Hospital, Qatar and initiation of thrombolytic therapy in the coronary care unit (door-to-needle time) is within the 30 minutes recommended by American College of Cardiology ! American Heart Association guidelines, the medical records were reviewed of 213 patients with ST-segment elevation myocardial infarction who were admitted through the Emergency Department to receive thrombolysis in the Coronary Care Unit in the twelve months May 2006-April 2007.

Medians were calculated for door-to-needle and pain- to-needle times and intermediate points.

The median pain- to-needle and pain-to-door times were 211 and 143 minutes respectively, both increasing significantly with the age of the patient and were shorter in men than in women.

The median door-to-needle time was 60 minutes with 11.7 % of the sample having a door-to-needle time within the recommended 30 minutes.

It is concluded that the need for transferring such patients from the emergency department to the coronary care unit of the hospital before the administration of thrombolysis incurs inevitable delays that can be ininiinizedby administering thrombolysis in the emergency department.