Comparison of Left Ventricular Systolic Function between Thrombolysed and Non-thrombolysed patients presenting with ST-Elevation Myocardial Infarction to a Tertiary Care Hospital

Abstract

Background: ST elevation myocardial infarction (STEMI) is a critical condition that requires prompt intervention to minimize myocardial damage and improve outcomes. Understanding the impact of thrombolysis on left ventricular systolic function in comparison to non-thrombolysed patients is crucial for optimizing treatment strategies and improving patient care in the post-STEMI period. This study aims to contribute valuable insights into the management of STEMI patients by evaluating the differences in left ventricular systolic function between thrombolysed and non-thrombolysed patients.

Methodology: This cohort study was conducted through non-probability consecutive sampling at Emergency Department, Faisalabad Institute of Cardiology, Faisalabad. Informed consent was obtained from attendant of patients. Demographic profile was also obtained including name, age, sex, h/o diabetes, IHD, smoking, family history and duration of pain. Two groups were formed on the basis of timing of presentation. Thrombolysed group consisted of patients who presented within 12 hours of onset of symptoms with ST-elevation on surface ECG and got thrombolytic. Non-Thrombolysed group consisted of patients presenting after 12 hours and didn’t get thrombolytic. Transthoracic echocardiography using Biplane Simpson’s method of these patients was done at the time of discharge and 6 weeks post discharge to assess Left ventricular systolic function. Data so collected was entered in predesigned Performa.

Results: In this study the mean age of the patients was 54.03±10.163 years with male to female ratio of 3.17:1. Mean value of LV systolic function among non-thrombolysed group patients was 31.58±10.53 while the mean value of LV systolic function among thrombolysed group patients was 47.77±9.24. The thrombolysis group showed better outcome than to non thrombolysed group.

Conclusion: According to the present study results it can be said that the non-thrombolytic patients showed significantly higher risk in terms of LV systolic dysfunction at 6 weeks post-discharge period as compared with the thrombolysed patients after ST elevation MI.