title: Delay of Fibrinolysis in ST- Elevation Myocardial Infarction: Results of an Investigation Conducted in a Single Center in Sousse Tunisia.
abstract: BACKGROUND
  The aim of our study was to assess the delay of fibrinolysis in ST elevation myocardial infarction (STEMI) in our region and to identify characteristics associated with prolonged delay.
  
  
  METHODS
  We analyzed clinical characteristics of a prospective cohort of unselected patients admitted for (STEMI). The study was conducted over three years 2007-2009 and 250 patients were included in a single center without capability of percutaneous coronary intervention.
  
  
  RESULTS
  The mean age of our patients was 58±13, 7 years. Ninety percent of our patients consult directly the emergency department and 61, (5%) of them were admitted within first 6 hours of onset of symptoms. Median time to reperfusion was 46 min. Predictor of this long delay to initiate fibrinolysis were inter-department decision OR 6; 95% CI 3,48-10,34, diabetes OR 2,25; 95% CI 1,28-3,96 age >58,4 years OR 1,97; 95% CI 1,19-3,25 and transfer from regional hospital to our center OR 1,78; 95% 1,03-3.07.
  
  
  CONCLUSIONS
  These results suggest that improvement in organization health care system can shorten delay to fibrinolysis in a center without percutaneous coronary intervention capability.
authors.affiliation: Department of Cardiology Farhat Hached Hospital 4000 Sousse, Tunisia.
authors.forename: Hatem
authors.initials: H
authors.lastname: Bouraoui
authors.affiliation: Department of Cardiology Farhat Hached Hospital 4000 Sousse, Tunisia.
authors.forename: Besma
authors.initials: B
authors.lastname: Trimeche
authors.affiliation: Department of Cardiology Farhat Hached Hospital 4000 Sousse, Tunisia.
authors.forename: Samia Ernez
authors.initials: SE
authors.lastname: Hajri
authors.affiliation: Department of Cardiology Farhat Hached Hospital 4000 Sousse, Tunisia.
authors.forename: Abdallah
authors.initials: A
authors.lastname: Mahdhaoui
authors.affiliation: Department of Cardiology Farhat Hached Hospital 4000 Sousse, Tunisia.
authors.forename: Meriem Ben
authors.initials: MB
authors.lastname: Romdhane
authors.affiliation: Department of Cardiology Farhat Hached Hospital 4000 Sousse, Tunisia.
authors.forename: Gouider
authors.initials: G
authors.lastname: Jeridi
keywords: Delay of fibrinolysis; ST-elevation myocardial infarction; reperfusion