ST-segment elevation myocardial infarction : evaluating the time interval from diagnosis to fibrinolysis at centres in the drainage area of Tygerberg Hospital, Cape Town, South Africa

• Published in: South African medical journal 2020-04, Vol.110 (4), p.327-331
• Main Authors: Doubell, A.F., Jalavu, T., Beyers, B.D., Griffiths, B.
• Format: Article
• Language: English
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.2020.v110i4.14330

Background. ST-segment elevation myocardial infarction (STEMI) is one of the main contributors to morbidity and mortality in South Africa (SA). Timeous intervention by means of percutaneous coronary intervention (PCI) or fibrinolysis can significantly improve the outcome of STEMI.Objectives. To determine the median time interval between diagnosis and fibrinolysis in patients presenting to centres within the drainage area of Tygerberg Hospital, Cape Town, SA, and compare it with the European Society of Cardiology (ESC) recommendation of 10 minutes.Methods. A retrospective medical record review of patients presenting to the above-mentioned centres between 1 March 2017 and 28 February 2018 was performed. The primary presenting centre, time between diagnosis and fibrinolysis and discharge medication were recorded, in addition to other relevant demographic information.Results. A total of 492 patients were identified, of whom 447 were included in the study. Three hundred and eighteen patients received fibrinolysis, of whom 18 (5.7%) were treated within 10 minutes of diagnosis. The median time interval between diagnosis and fibrinolysis was 67 (interquartile range (IQR) 32.5 - 122.5) minutes.Conclusions. Most patients received fibrinolysis >10 minutes after diagnosis, which indicates suboptimal therapy when compared with the ESC guidelines. Future studies should investigate the factors prolonging this therapeutic delay.