European Journal of Cardiovascular Medicine

Background:  ST-segment elevation myocardial infarction (STEMI) is a life-threatening emergency. Although primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy, a large proportion of patients from less developed areas in China are still unable to present or be transferred to a hospital with PCI capacity within the required time frame. A previous study reported that less than half of hospitalized patients with STEMI from military hospitals received primary PCI in China. Materials and Methods: This is a retrospective observational study. Case records of patients presenting to ICCU with chest pain, diagnosed as acute STEMI, in whom primary PCI was not feasible within 120 minutes of diagnostic ECG. Study was conducted on 50 patients in Department of Emergency Medicine, Sri Siddartha Medical College and Research Centre, B.H Road, Agalkote, Tumkur, Karnataka from January 2023 to December 2023. Protocol- Inj. Tenecteplase, Adjuvant Medication as per Physician’s instructions. Results: 50 patients of STEMI are studied in Department of Emergency Medicine, Sri Siddartha Medical College and Research Centre, B.H Road, Agalkote, Tumkur, Karnataka, India, with the above criteria. The rate of Clinically Successful Thrombolysis (CST) with tenecteplase was 92%. Those who received within 3 hours of symptoms was 94%. Those who received between 3-6 was 89% and those after 6 hours was 84%. STE resolution was observed in 94% of patients. Within 90 minutes, STE resolution was 91%. Mean time for resolution of STE was 70 minutes. 92% has relief of chest pain. Mean time of chest pain relief was 58 minutes. Within 30 minutes, 35% of patients had relief of chest pain. Reinfarction occurred in 2% of patients. 3 patients died before discharge. No incidence of Hypotension was observed. The incidence of bleeding excluding ICH is 2%. Incidence of stroke is 2%. Conclusion: Thrombolytic therapy is an evidence-based treatment for STEMI. Our study further reinforces the safety and efficacy of tenecteplase in Indian STEMI patients. Our study reconfirms the importance of early thrombolysis for successful thrombolysis, especially in Indian scenario where reaching PCI centre may not be immediately possible.