Effect of infarct site on the clinical endpoints of thrombolytic-treated ST-elevation myocardial infarction |
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| Affiliation: | 1. Department of General Medicine, University of Missouri Health Care, Columbia, MO, USA;2. Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, MO, USA;3. Medical School of Jordan University of Science and Technology, Irbid, Jordan;1. Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China;2. Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China;3. Weil Institute of Emergency and Critical Care Research, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA;4. Department of Emergency Medicine, The First People''s Hospital of Foshan, 81 Ling Nan Road North, Foshan, Guangdong, 528000, China;1. Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Republic of Korea;2. Department of Emergency Medicine, Seoul National University Bundang Hospital, Republic of Korea;1. Health Science University, Gazi Yasargil Research and Training Hospital, Emergency Department, Diyarbakır, Turkey;2. Health Sciences University, Gazi Yasargil Research and Training Hospital, Biochemistry Department, Diyarbakır, Turkey;3. Dicle University, School of Medicine, Department of Physiology, Diyarbakır, Turkey;1. Department of Urology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey;2. Program of Medical Laboratory Techniques, Vocational School of Health Sciences, Karadeniz Technical University, 61080 Trabzon, Turkey;3. Department of Nutrition and Dietetics, Faculty of Health Sciences, Karadeniz Technical University, 61080 Trabzon, Turkey;4. Department of Histology and Embryology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey;5. Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey;6. Department of Urology, Faculty of Medicine, Akdeniz University, 07100 Antalya, Turkey;7. Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey |
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| Abstract: | IntroductionSome studies suggest better outcomes after the use of thrombolytics in inferior ST-elevation myocardial infarction (STEMI) compared to other locations. The goal of this study is to compare the clinical endpoints of thrombolytic-treated STEMI based on coronary artery distribution.MethodsThe study population was extracted from the 2014 Nationwide Readmissions Data using the International Classification of Diseases, Ninth Revision, Clinical Modifications codes for STEMI, thrombolytic infusion, and complications of STEMI. Primary study endpoints included in-hospital all-cause mortality, length of hospital stay (LOS), cardiogenic shock, and mechanical complications of STEMI.ResultsA principal diagnosis of thrombolytic-treated STEMI was identified for in 1231 patients (mean age 61.5 years; 26.5% female). Four hundred and thirty-one STEMIs occurred in the left anterior descending (LAD) artery distribution, 124 in the left circumflex (LCX) artery distribution, and 676 in the right coronary artery (RCA) distribution. In comparison to the LAD and LCX distributions, thrombolytic-treated STEMIs in the RCA distribution were associated with lower mortality (6.5% with LAD, 5.7% with LCX, and 3.6% with RCA; p = 0.02), fewer cardiogenic shock (12.3% with LAD, 12.1% with LCX, and 7.7% with RCA; p = 0.01), and shorter LOS (4.5 days with LAD, 3.9 with LCX, and 3.6 days with RCA; p < 0.01). Mechanical complications showed no significant difference based on coronary distribution (2.3% with LAD, 3.2% with LCX, and 1.2% with RCA; p = 0.17).ConclusionsThrombolytic-treated STEMIs in the RCA distribution were associated with lower in-hospital all-cause mortality, cardiogenic shock, and shorter LOS. Mechanical complications were not different based on coronary distribution. |
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