Abstracts of Dissertations

s of Dissertations December 2014 Exit Assessment Exercise A RETROSPECTIVE REVIEW OF FIBRINOLYSIS TREATMENT TO ST EVATING MYOCARDIAL INFARCTION IN A HONG KONG REGIONAL HOSPITAL Dr Kong Chun Cheong, Department of Medicine, Tseung Kwan O Hospital (December 2014 Cardiology Exit Assessment Exercise) Objective Acute myocardial infarction is one the leading causes of death in Hong Kong and modern society, in which ST elevating myocardial infarction (STEMI) carries a high mortality. Fibrinolysis, one of the reperfusion therapies for treatment of STEMI, can significantly reduce the mortality. The aim of the study is to review the fibrinolysis treatment in a local regional hospital which is incapable of primary percutaneous coronary intervention (PCI) and the outcome. Methods The clinical records of all patients admitting to Tseung Kwan O Hospital within the period from 2012 to 2014 with diagnosis of STEMI and given fibrinolysis were retrieved. Their demographic data, details of fibrinolysis and outcome were assessed and analyzed. Results Total 133 patients, account for 43.2% of all STEMI cases (133 out of 308), were given fibrinolysis during the mentioned period of time. More male patients (89.5% vs 10.5%) received fibrinolysis and they were younger (59.45 vs 75.64) than female patients. The mean FMC (first medical contact) to needle time was 60.4 minutes, and around 57.1% patients achieved 30 minutes target of FMC to needle time. The successful rate of fibrinolysis was 60.9% and significantly higher in male than female (63.9% vs 36%). The in hospital mortality rate was 10.5%, 30-day mortality was 12% and half year mortality was 12.8%. And 63.9% patients received coronary intervention either at the same admission or post discharge. Conclusion The rate (43.2%) of patients with STEMI receiving reperfusion therapy was inadequate and there was still room for improvement in the timing of fibrinolysis. Early recognition of STEMI cases, prompt administration of fibrinolysis and development of logistics for arrangement of patient for early PCI were of paramount importance in managing these patients.