ArticleCureus2025
In-Hospital Outcomes of Thrombolysed Versus Late-Presenting Non-Thrombolysed Patients With Acute ST-Segment Elevation Myocardial Infarction.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundEarly thrombolytic therapy substantially improves outcomes in patients with acute coronary syndrome (ACS), yet its timely administration remains suboptimal in many developing regions.
objectiveTo evaluate in-hospital outcomes of patients with acute ST-elevation myocardial infarction (STEMI) receiving timely thrombolysis compared with those managed with late or no thrombolysis.
methodsThis comparative observational study included 136 consecutive ACS patients, divided equally into thrombolysis (n = 68) and late/non-thrombolysis groups (n = 68). Demographic data, risk factors, clinical presentation, and in-hospital outcomes, including mortality, high WHO CVD risk at presentation, recurrent ischemia, bleeding, and resource utilization, were collected. Data were analyzed using SPSS version 26 (IBM Corp., Armonk, NY), including t-tests, chi-square or Fisher's exact tests, and multivariate logistic regression to adjust for confounding variables. Significance was set at p < 0.05.
resultsPatients receiving thrombolysis showed significantly lower mortality (2 (2.9%) vs 12 (17.6%), p = 0.01), heart failure (10 (14.7%) vs 28 (41.2%), p < 0.001), cardiogenic shock (4 (5.9%) vs 14 (20.6%), p = 0.01), and recurrent ischemia (4 (5.9%) vs 14 (20.6%), p = 0.01). High WHO cardiovascular risk at presentation was also less frequent among thrombolyzed patients (12 (17.6%) vs 30 (44.1%), p < 0.001). Bleeding complications were rare and comparable (6 (8.8%) vs 8 (11.8%), p = 0.57), supporting the safety of timely thrombolysis. Multivariate logistic regression confirmed that thrombolysis independently reduced composite adverse outcomes (adjusted OR = 0.42; 95% CI 0.25-0.70; p = 0.001).
conclusionTimely thrombolytic therapy significantly improves in-hospital outcomes and can be safely administered in ACS patients when delivered within recommended time windows.
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