Outcome of Recombinant Tissue Plasminogen Activator in ST-Segment Elevation Myocardial Infarction in Buriram Hospital
Phattaraphong Pheerawong MD*, Bulan Plienthaisong RN*
Affiliation : * Department of Medicine, Buriram Hospital, Buriram, Thailand
Objective : To study clinical outcomes of recombinant tissue plasminogen activator (alteplase) as primary fibrinolytic drug
in patients with acute STEMI in Buriram Hospital.
Material and Method: Data on demographics, medications, in-hospital outcomes, and angiography were collected from
a prospective registry of STEMI patients admitted by STEMI fast track from January 1, 2011 to December 31, 2013.
Results : During the 3-year period, 97 consecutive patients with STEMI who received alteplase were enrolled. The mean
age was 64.3 year and 75.3% were male. There were high prevalence of dyslipidemia and current smoking. Median time
from symptom onset to hospital presentation was 170 minutes. Median door to needle time was 30 minutes. Thrombolytic
therapy was started in 30 minutes in 55.7% of cases. Overall bleeding was 19.6%. Intracranial hemorrhage was 1.0%
of patients. ST-segment resolution was found in 79.4% of patients. In-hospital mortality was 11.3%. Angiographic data
(n = 45) in patients with clinical reperfusion (n = 32), TIMI flow grade 2 and 3 combined was 90.6% and TIMI flow
grade 3 was 56.3%. Revascularization was performed in 90.6%.
Conclusion : Alteplase in acute STEMI provided good clinical reperfusion with minimal major bleeding complication. Most
of patients with clinical reperfusion required additional percutaneous coronary intervention to fix residual stenosis of infarct
related artery.
Keywords : Acute coronary syndrome, ST-segment elevation myocardial infarction, Thrombolytic therapy, Tissue plasminogen activator
