Why the study?
What are the recent trends and modes of reperfusion therapy in patients presenting with acute STEMI in a South Indian tier-3 city?
What are the recent trends and modes of reperfusion therapy in patients presenting with acute STEMI in a South Indian tier-3 city?
Despite increases in primary PCI and tenecteplase, streptokinase remains the dominant reperfusion strategy for STEMI in a South Indian tier-3 city, with 14% of patients receiving no reperfusion.
Streptokinase remains dominant despite other options; extends regional data but leaves open questions on reducing late presentations in tier-3 cities.
AIMS: In India, larger proportions of patients with ACS present with STEMI. We sought to study the recent trends of reperfusion in patients of acute STEMI. METHODS AND RESULTS: 1905 patients presenting with acute STEMI enrolled. 1636 (86%) received some form of reperfusion therapy. Streptokinase, 1235 (65%) patients, was the most common mode of reperfusion therapy used followed by primary PCI (205, 10.7%) and tenecteplase (196, 10%). 269 (14%) did not receive any form of reperfusion therapy, the most common reason being late presentation in 230 (85.7%). Patients presenting with STEMI increased from 297 to 446 comparing first and last half-year of study period. The PCI and tenecteplase numbers increased from 19 to 68 and 27 to 97 respectively. CONCLUSION: There was 20% increase in STEMI every year. Younger patients are least likely to receive primary PCI or tenecteplase. 1 in 8 patients of STEMI did not receive any form of reperfusion therapy.
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Kunwar et al. (2012) studied this question.
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