ArticleInternational journal of cardiology. Heart & vasculature2019
Clinical characteristics and outcomes of ST-segment elevation myocardial infarction in a low income setting in rural Bangladesh.
Article in International journal of cardiology. Heart & vasculature, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Acute myocardial infarction treatment delay in South Asia: a systematic review and meta-analysis.Future cardiology · 2025Pooled it
- Incidence of Recurrent Adverse Cardiovascular Events Among Patients With Acute Myocardial Infarction During the First Wave of the COVID-19 Pandemic in Bangladesh: A Prospective Observational Study.Health science reports · 2025Article
- Presentation, care, and outcomes of patients with NSTEMI according to World Bank country income classification: the ACVC-EAPCI EORP NSTEMI Registry of the European Society of Cardiology.European heart journal. Quality of care & clinical outcomes · 2023Article
- Acute coronary syndrome treatment delay in low to middle-income countries: A systematic review.International journal of cardiology. Heart & vasculature · 2021Article
- In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh.BMC cardiovascular disorders · 2021Observational
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5 authors.
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Abstract
backgroundIn rural areas of Bangladesh, the majority of patients with ST segment elevation myocardial infarction (STEMI) have little access to reperfusion therapy. Even though thrombolysis can be an affordable life-saving treatment in a low income setting, there are few publications in regards to the clinical and socioeconomic features of STEMI with thrombolytic therapy in rural Bangladesh.
methodThe information of the patients who were admitted for STEMI between 2010 and 2016 from one rural hospital were collected and reviewed. This audit evaluated clinical outcomes and socioeconomic characteristics of the patients.
result164 patients with STEMI were identified in the period and 136 patients (82.93%) underwent thrombolysis. The mean pain-to-door time was 472 min (7.87 h ± 12.40). Only 5.49% of the patients traveled to hospital by ambulances. Overall in-hospital mortality rate and major adverse cardiovascular event (MACE) after STEMI were 19.51% (32/164), 23.17% (38/164), respectively. The need of inotropics (Odds ratio [OR] 16.43, 95% confidence interval [CI] 1.99-135.75, P < 0.01), the use of defibrillation due to ventricular arrhythmias (OR 33.58, 95% CI 2.96-380.49, P < 0.01) were independent predictors of increased in-hospital mortality.
conclusionIn a rural hospital of Bangladesh, in-hospital mortality rate after STEMI is high in spite of thrombolysis and adherence to published guidelines. The prolonged pain-to-door time and the poor coverage of ambulance services in our study highlight the need of community awareness of acute coronary syndrome and comprehensive emergency medical services in rural Bangladesh.
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