Publication:

Clinical profile of ST-elevation myocardial infarction patients from a tertiary care hospital in Northern India

Background Our aim was to the study clinical and epidemiological profile of patients presenting with ST-elevation myocardial infarction (STEMI).

Methods We did a single centre cross-sectional observational study of 200 patients presented with STEMI to a tertiary referral centre in Northern India from January 2016 to November 2017. All patients above 18 years of age admitted with diagnosis of STEMI were included in the study.

Results The mean age of study population was 55.75±12.5. The most common chief compliant was chest pain (95.1%). The anterior wall myocardial infarction (AWMI) accounted for 60.5% of all STEMI patients. The median duration from onset of symptoms to presentation to hospital was 7.93±6.58 hours. Cardiogenic shock was observed in 10.5% patients. Most common risk factor noted was smoking (63%). Mean left ventricular ejection fraction (LVEF) was less in AWMI (47±9.09) as compared to inferior wall myocardial infarction (IWMI) (50.72±7.14) (p<0.05). Among 200 cases studied, 11.5% cases developed post MI-Angina. Among arrhythmic complications, sinus bradycardia was most common (17.5%).

Conclusions Our study represents the predominance of AWMI as the initial acute coronary syndrome (ACS) presentation with a considerable delay in first medical contact. Complications like cardiogenic shock, arrhythmia were frequently observed. The biggest barrier to uniform STEMI care in developing nations is nonexistence of regional systems of care and this need to be improved.