Clinical profile and outcome of st- segment Elevation myocardial infarction patients presented To jimma university medical center, jimma, Southwest Ethiopia: a two year retrospective study

Abstract

Background: ST-segment elevation myocardial infarction (STEMI) is one of the most deadly kinds of acute coronary syndrome (ACS), accounting for one of the leading causes of mortality worldwide. STEMI continues to raise internationally, with a major impact on low and middle-income countries, particularly Africa, due to inadequate healthcare infrastructure and patients' late presentation. Despite the expansion of the disease magnitude, clinical profile and outcome of STEMI is not thoroughly investigated in resource constraint settings like Ethiopia. Objective: The study was conducted to assess the clinical profile and outcome of patients presented with ST segment elevation myocardial infarction at JUMC. Method: A retrospective cross-sectional study design was conducted from STEMI patient’s medical chart record that fulfill the inclusion criteria using a structured questioner to assess the clinical profile and outcome at JUMC from November 1, 2022 to December 31, 2024. The collected data were checked, entered and analyzed using SPSS software version 27 and P-value less than 0.05 was considered as statistically significant. Result: A total of 73 patients were diagnosed with STEMI and met the inclusion criteria and included in the study. The M: F ratio was 3.88:1, with 58 (79.5%) being male. The median age was 60 years (IQR 45-70). A total of 62 patients out of 73, or 84.9% of the total, reported having chest pain. The average duration between the onset of symptoms and hospital presentation was 91.33 hours (3.8 days). Approximately 67 patients (91.8%) had echocardiography performed and 8.2% of patients had LVEF <30%. Every patient received dual antiplatelet (aspirin and clopidogrel), and 12.3% of patients received thrombolytic therapy. The in-hospital mortality was 13.7%. Predictors of in hospital mortality in JUMC were killip class (P=0.016) and major arrhythmias (P=0.04). Conclusion: The medical management of patients with STEMI was in accordance with international guidelines, even though only nine patients received thrombolytic and none received PCI. STEMI patients have a delayed presentation to the hospital from the onset of symptoms, and their risk profiles are comparable to those of the developed world, but their mortality rates are higher. Having an arrhythmia and higher killip class were found to be independent predictors of in-hospital mortality at Jimma University Medical Center