Factors associated with reperfusion failure of ST-elevation myocardial infarction following thrombolytic therapy in Somdejphrajaotaksin Maharaj hospital, Tak province

Abstract

This study objectivity to study the factors associated with reperfusion failure in ST-elevation acute myocardial infarction (STEMI) patients received thrombolytic therapy at Somdetphrajaotaksin Maharaj Hospital. This is a cross-sectional analytical study collected data between July 2019 and June 2024, involving acute ST-segment elevation myocardial infarction (STEMI) patients who received thrombolytic therapy. Data were analyzed using descriptive statistics, tests of differences among variable factors, and binary logistic regression analysis to explore associations between variable factors and results were presented with adjusted odds ratios (adjusted OR) and 95% confidence intervals (95%CI). The level of statistical significance was set at 0.05. The 84 patients were included with a mean age of 66.3 ± 11.34 years. 95.2% of patients received Streptokinase, while 4.8% of patients received Tenecteplase. Reperfusion failure occurred in 48.8% of patients, with 75.6% being male and 24.4% female. Three factors contributing to reperfusion failure are age (adjusted OR 1.081, 95%CI 1.001-1.168; p = 0.047, mean age 69.5 ± 9.72 years), alcohol consumption (adjusted OR 8.893, 95%CI 1.653-47.837; p = 0.011), and HbA1C levels (adjusted OR 3.081, 95%CI 1.085-8.746; p = 0.035). Complications following thrombolytic therapy included hypotension in 16.7% of patients and bleeding in 9.5%, which is consistent with previous studies. This study found that age, alcohol consumption, and HbA1C were factors contributing to reperfusion failure in acute STEMI patients. Further studies should include network hospitals to increase the sample size, which may reveal associations with other variable factors.