Last update:
   07-Jul-2019
 

Arch Hellen Med, 37(4), July-August 2019, 494-502

ORIGINAL PAPER

Comparison between percutaneous coronary intervention and thrombolytic therapy
in patients with ST-elevation myocardial infarction Ιmplications for cost effectiveness

J.K. Fajar,1 B.A. Mahdi,2 T. Heriansyah,3 M.S. Rohman4,5
1Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh
2Department of Emergency, Aisyiyah Hospital, Malang
3Department of Cardiology and Vascular Medicine, Syiah Kuala University, Banda Aceh
4Department of Cardiology and Vascular Medicine, Brawijaya University, Malang
5Brawijaya Cardiovascular Research Center, Brawijaya University, Malang, Indonesia

OBJECTIVE To compare length of stay (LOS) and major adverse cardiac events (MACE) between thrombolytic therapy and percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction.

METHOD A retrospective study was conducted at Aisyiyah Hospital from January 2014 to December 2017. Data on the revascularization method and outcome related to LOS and MACE were extracted from the medical records. Multiple logistic regression was used to assess the relationship between revascularization method and LOS, and MACE. In addition, a meta-analysis was conducted to summarize relevant findings from other regions.

RESULTS A total of 294 patients with ST-elevation myocardial infarction (STEMI) between January 2014 and December 2017 were enrolled in this study. Of these, 186 patients were treated with thrombolytic therapy and 108 patients were treated with PCI. The findings showed that thrombolytic therapy was associated with increased risk of longer LOS, cardiogenic shock, and death compared with PCI. In addition, the meta-analysis showed that thrombolytic therapy was related with increased risk of prolonged LOS and reinfarction.

CONCLUSIONS The higher LOS and MACE observed in the thrombolytic group means that thrombolytic therapy is associated with greater morbidity and incurs higher costs than PCI for treating patients with STEMI.

Key words: Cost efficiency, Myocardial infarction, Percutaneous coronary intervention, Thrombolytic therapy.

© Archives of Hellenic Medicine