In-hospital Mortality with Relation to Time of Presentation in Patients with Acute ST Elevation Myocardial Infarction

Aim: To determine the frequency of in-hospital mortality in different groups with relation to time of presentation in patients of acute ST Elevation Myocardial Infarction (STEMI). Methods: This Descriptive Case Series conducted in the Department of Cardiology, Punjab Institute of Cardiology, Lahore from December 2011 to June 2012. Two hundred patients of acute ST elevation myocardial infarction fulfilling the inclusion criteria from emergency department of PIC Lahore were enrolled after informed consent. This study population was divided into four groups. Group I was consisted of patients presenting in <3 hours of onset of symptoms, Group II, patients presenting in 36 hours after symptom onset, Group III, patients presenting in 6-12 hours and Group IV was comprise of patients presenting after 12 hours of onset of symptoms of acute myocardial infarction. Routine protocol was offered to each patient and all patients will be followed for mortality for four days. Results: Mean age of the patients was 55.5 +/- 13.2 years. Out of 200 patients 148 (74%) were male and 52 (26%) were female. Out of 200 patients, 108 (54%) were smokers. Hypertension was found in 94 (47%) of the patients. 80 (40%) were having diabetes. Out of 200 patients 37(18.5%) died during hospital admission. Conclusion: Delayed presentation is associated with older age and female gender. Patients presenting late are in more advanced Killip class and are less frequently thrombolysed and are predisposed to increased in-hospital mortality.