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ISSN 1029-3043 (Electronic)

2022, Number 4

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Medicentro 2022; 26 (4)

Prognostic factors of thrombolytic failure in patients diagnosed with acute myocardial infarction

Palacio PH, Rey GKB, Castillo CJJ

Language: Spanish
References: 15
Page: 853-865
PDF size: 344.17 Kb.


ABSTRACT

Introduction: the most important therapeutic measure in patients with ST-segment elevation acute myocardial infarction is reperfusion of the ischemic territory; fibrinolysis is the primary strategy in many hospitals. Early diagnosis of those patients with risk of failed thrombolysis is vital.
Objective: to identify prognostic factors of thrombolytic failure in patients diagnosed with ST- segment elevation acute myocardial infarction.
Methods: a descriptive and prospective study including patients treated in the Emergency department at "Joaquín Albarrán" Clinical and Surgical Hospital, who were diagnosed with the previously mentioned disease and treated with recombinant streptokinase, between November 2018 and May 2020. A number of 66 patients were included in the investigation. Age, gender, arterial hypertension, diabetes mellitus, time between onset of symptoms and onset of fibrinolysis, location of the infarction, QRS complex duration, duration and depth of the wave were the analyzed variables.
Results: thrombolysis failed in 27 patients (40.9%). Time of performing thrombolysis, duration and depth of the Q wave, as well as the QRS duration showed values with significant differences between both groups (p<0.05). The multivariate analysis confirmed the duration and depth of the Q wave as independent factors, predictors of thrombolysis failure: (OR= 14.50; 95% CI 1.58-132.33); (OR: 1.69; 95% CI 1.27-2.26), respectively.
Conclusions: the analysis of the depth and duration of the Q wave in the initial electrocardiogram of the studied patients allows us to predict a subpopulation of patients with risk of failed thrombolysis.


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