Consequence and factors related to not offering reperfusion therapy in STEMI

Varied reasons existed for not offering reperfusion therapy in ST elevation myocardial infarction and results in poor outcomes, and if related factors could be delineated, corrective measures can be attempted.

We compared variables between participants not receiving reperfusion therapy and those receiving single reperfusion therapy. Multivariate analysis examined the contribution of non-reperfusion therapy to death and factors related to it.

Non-reperfusion therapy was older and had a lower frequency of typical chest pain, but more dyspnea, and post cardiac resuscitation. They had more heart failure and death. Non-reperfusion therapy was an independent factor related to cardiac death, and factors related to non-reperfusion therapy were age, type of hospital, presenting features on admission (dyspnea and post cardiac resuscitation), lack of typical chest pain, and not being referred to.

Non-reperfusion therapy had 2 to 3 times higher in-hospital mortality. Factors related to not offering reperfusion therapy, aside from age, appeared to be amendable to better management.