COMPARISON OF SURVIVAL TIMES AMONGST PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION, PHARMACO-INVASIVE AND THROMBOLYTIC THERAPY FOR ACUTE ST ELEVATION MYOCARIAL INFARCTION IN A TERTIARY CARE HOSPITAL: A SURVIVAL ANALYSIS

Abstract

Background: Acute myocardial infarction remains a time-sensitive medical emergency associated with significant morbidity and mortality. Research supports the superiority of PPCI over fibrinolytic therapy that can improve outcomes when delivered within a specified timeframe, however; effectiveness of treatment options in the terms of survival over the period of time has not been tested in our setup.

Objective: To compare the survival times in patients with acute myocardial infarction treated with PPCI,PI and streptokinase.

Material and Methods: A prospective study was conducted in Armed Forces Institute of Cardiology, Rawalpindi from Jan 2016 to July 2018 using consecutive sampling. Total 294 patients fulfilling the inclusion criteria were stratified into three groups i..e group I patients who underwent PPCI and group II who underwent parmaco-invasive therapy and group III who were administered streptokinase. All the groups were followed for 30 months. In this study the probability of the patients to survive after PPCI at the end of 6 months duration was found to be 96% for PPCI, 93% for PI and 75% for SK. Similarly, probability of the patients to survive at the end of 30 months in case of PPCI was 91%, 89% in case of PI and 64% for SK.

Conclusions: This study will help determine the benefits of PPCI over fibrinolysisin terms of survival and will play a pivotal role in policy decisions for sustainability of a 24/7 PPCI reperfusion strategy to decrease overall mortality related to acutemyocardial infarction.