Reperfusion strategy for ST-segment elevation myocardial infarction: trend over a 10-year period

Area of Science:

• Cardiology
• Interventional Cardiology
• Public Health

Background:

• ST-segment elevation myocardial infarction (STEMI) requires timely reperfusion.
• Historically, thrombolytic therapy was the primary reperfusion strategy.
• The advent of primary percutaneous coronary intervention (PCI) has shifted treatment paradigms.

Purpose of the Study:

• To analyze the 10-year trend of reperfusion strategies for STEMI.
• To assess the adoption of PCI versus thrombolytic therapy.
• To identify reasons for the non-receipt of reperfusion therapy in STEMI patients.

Main Methods:

• A case series design was employed.
• Data were collected from a regional hospital in Hong Kong.
• Patient records from January 2000 to December 2009 were reviewed.

Main Results:

• Primary PCI use increased significantly from 1.6% in 2000 to 30.6% in 2009.
• Thrombolytic therapy use decreased from 57.4% to 35.0% during the same period.
• Delayed presentation (45.1%) was the most common reason for no reperfusion.

Conclusions:

• Primary PCI is increasingly the preferred reperfusion strategy for STEMI.
• Thrombolytic therapy remains a significant, though declining, treatment option.
• Addressing barriers to reperfusion, such as delayed presentation, is crucial.