Consequence and factors related to not offering reperfusion therapy in STEMI.
BACKGROUND
Varied reasons existed for not offering reperfusion therapy in ST elevation myocardial infarction and results in poor outcomes, and if related factors could be delineated, corrective measures can be attempted.


METHODS
We compared variables between participants not receiving reperfusion therapy and those receiving single reperfusion therapy. Multivariate analysis examined the contribution of non-reperfusion therapy to death and factors related to it.


RESULTS
Non-reperfusion therapy was older and had a lower frequency of typical chest pain, but more dyspnea, and post cardiac resuscitation. They had more heart failure and death. Non-reperfusion therapy was an independent factor related to cardiac death, and factors related to non-reperfusion therapy were age, type of hospital, presenting features on admission (dyspnea and post cardiac resuscitation), lack of typical chest pain, and not being referred to.


CONCLUSIONS
Non-reperfusion therapy had 2 to 3 times higher in-hospital mortality. Factors related to not offering reperfusion therapy, aside from age, appeared to be amendable to better management.
Jintapakorn
Woravut
W
Division of Cardiology, Department of Internal Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand. jworavut@medicine.psu.ac.th
Lim
Apiradee
A
Yipintsoi
Tada
T
Moleerergpoom
Worachat
W
Srimahachota
Supot
S
Sriyadthasak
Odthon
O
D000368:Aged; D017023:Coronary Angiography; D003657:Decision Making; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015425:Myocardial Reperfusion / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome