Treatment selection factors and outcome comparison in acute myocardial infarction

Background: The reopening of occluded arteries in myocardial infarction can be achieved through invasive and non-invasive methods. Objectives: This study aimed to determine treatment factors and outcomes comparison in acute myocardial infarction patients. Methods: This cross-sectional and retrospective study examined the hospitalization data of 252 myocardial infarction patients referred to Ayatollah Mousavi Hospital from April 2021 to March 2022. The patient's demographic and clinical data, factors influencing treatment intervention selection, and clinical outcomes were assessed. Data were analyzed using the Chi-square test/Fisher's exact test, multiple logistic regression analysis, and ANOVA in SPSS v.22 software. Results: Primary percutaneous coronary intervention (PPCI) comprised 45.6% of treatments, with thrombolytic therapy comprising 35.3%. Multiple regression analysis revealed that the availability of a 24/7 operational catheterization lab and immediate access to an on-call interventional cardiologist were significant predictors of treatment selection (P< 0.05). (P<0.05). The success rate of PPCI was 87.2% and thrombolytic therapy was 58.9%. Outcomes such as hospitalization length, analgesia dose, rehospitalization, and mortality rate over a year showed no significant statistical difference between the PPCI and thrombolytic groups (P>0.05). Conclusion: Access to equipment and specialized manpower is essential for PPCI. There were no complications or clinical outcomes that differed between patients treated with PPCI and thrombolytic therapy. Thrombolytic therapy remains a viable alternative to PPCI when timely intervention is not feasible.