CLINICAL AND EPIDEMIOLOGICAL PROFILE OF ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS WITH REFERENCE TO PREHOSPITAL AND IN-HOSPITAL DELAYS: A PROSPECTIVE OBSERVATIONAL STUDY
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Keywords
ST-elevation myocardial infarction, Prehospital delay, In-hospital delay, Reperfusion therapy, Primary PCI, Thrombolysis, Risk factors, Mortality
Abstract
Background: ST-elevation myocardial infarction (STEMI) continues to be a major cause of morbidity and mortality worldwide, with earlier age of onset and higher prevalence in South Asian populations. Despite the availability of reperfusion therapies, prehospital and in-hospital delays remain significant contributors to adverse outcomes.
Objectives: This study aimed to analyze the clinical and epidemiological profile of STEMI patients presenting to a tertiary care hospital, evaluate the magnitude of treatment delays, and assess associated complications and outcomes.
Methods: A prospective observational study was conducted on 161 consecutive patients with confirmed STEMI admitted to the Emergency Department of a tertiary care center over a one-year period. Data regarding demographics, risk factors, symptom onset, prehospital and in-hospital delays, reperfusion therapy, complications, and outcomes were collected through structured questionnaires and medical records. Statistical analysis was performed using R software, with categorical variables expressed as percentages and continuous variables as mean ± SD.
Results: The mean age of patients was 56.8 ± 11.7 years, with a male predominance (72.7%). Hypertension (58.4%), diabetes mellitus (44.1%), and smoking (39.7%) were the most prevalent risk factors. The mean prehospital delay was 178 minutes, with 62% of patients arriving beyond the recommended 120-minute window. Thrombolysis was administered in 68% of cases, while 21% underwent primary PCI. Complications included arrhythmias (21.1%), cardiogenic shock (11.2%), and pulmonary edema (7.5%). The in-hospital mortality rate was 9.9%.
Conclusion: STEMI patients in this cohort presented late, with significant delays contributing to high complication rates and mortality. Strengthening community awareness and improving emergency medical services are crucial to reducing treatment delays and improving outcomes.
References
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Pooja Verma
Assisstant Professor, Santosh Medical College Ghaziabad.
Dr.Arpana Singh
Senior Consultant, Department of Emergency Medicine, Kauvery Hospital Tirunelveli.
Dr Arti Verma
Assisstant Professor, Department of Community Medicine, Sarojini Naidu Medical College Agra.
