Evaluation of fibrinolytic medical therapy for patients with acute myocardial infarction

   BACKGROUND: Fibrinolytic therapy is the standard therapeutic method for patients with acute myocardial infarction (AMI). This study endeavored to assess the delay in arrival to the emergency department and door to needle time for thrombolytic therapy.    METHODS: This study was conducted on ۸۰ patients with AMI whom referred to our clinic from January ۲۰۰۹ to January ۲۰۱۰. We measured time of arrival, needle time and door to needle time for all patients. Moreover, the relations of these times to some variables such as age, gender and the referred shift of emergency department personnel were calculated.    RESULTS: A total of ۸۰ patients, ۶۲ (۷۷.۵%) male and ۱۸ (۲۲.۵%) female were evaluated for thrombolytic therapy. The arrival time of overnight shifts was ۱۴.۵۹ ± ۱.۲۳ minutes shorter than other shifts. The median door to needle time was ۴۶.۵۶ minutes and the mean time of the onset of chest pain to arrival at the emergency department was ۱۹.۴۴ minutes. Seventy-two patients (۹۰%) received fibrinolytic therapy within the first ۳۰ minutes of arrival. The needle time was significantly longer in the night shift (P < ۰.۰۵) (between ۸ to ۱۴ minutes), while the time of receiving Streptokinase therapy in the other shifts was not meaningfully different. Finally there was a statistically significant difference between the referred shifts and needle time (P < ۰.۰۵).    CONCLUSION: Despite our good results for door to needle time, to improve and attain the gold standard’s limits in administering fibrinolytic therapy, improvement of policies like training the personnel to shorten this time is recommend.         Keywords: Fibrinolytic Therapy, Door to Needle Time, Acute Myocardial Infarction