Background : The management of myocardial infarction with persistent ST segment-elevation (STEMI) is based on an
urgent reperfusion therapy. Fibrinolysis is the reperfusion approach commonly used in emergency department (ED).
The aim of this study was to identify clinical criteria predictive of fibrinolysis success among patients admitted for STEMI
to emergencies within 12 hours.
Methods : We conducted a single-center, prospective, observational study. Inclusion of patients with STEMI thrombolysed
by Tenecteplase. Fibrinolysis success was defined according to clinical and Electrocardiogram criteria. Multivariate study is
used to identify the factors associated with thrombolysis success.
Results : Two hundred and sixty-three patients were included. Mean age= 57 ± 16 years. Sex ratio= 6.96. The average time
lost before admission for chest pain was 184 ± 126 min (30 min to 12 hours). The average success rate of thrombolysis was
72.2%. In multivariate analysis, the independent predicting factors of fibrinolysis success were: the delay from onset of chest
pain to the ED visit being less than 180 min [OR=1.5; IC 95%= 1-2.26; p=0.05] and the delay for the first medical contact
to qualified ECG being less than 10 min [OR= 1.5; IC 95% = 1-2.36; p=0.05].
Conclusions : Regarding the management of myocardial infarction with persistent ST segment-elevation in emergencies,
the independent predictors of a fibrinolysis success are the short delays from onset of the chest pain to the ED visit being
less than 180 minutes, and the delay between the first medical contact and the ECG interpretation being less than 10 min.