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Abstract

Background: The ST-segment elevation myocardial infarction is a severe cardiac emergency with a significant dependence on early treatment for outcomes. Thrombolysis plays a central role in circumstances where a percutaneous coronary intervention facility is not accessible. Late presentation more frequently makes a patient a non-candidate for early thrombolysis, further compromising prognosis. Objective: To determine and compare the in-hospital outcomes of patients with acute ST-segment elevation myocardial infarction who received thrombolysis versus those who presented late and were not thrombolysed. Study Design: Descriptive cross-sectional study. Duration and Place of Study: Conducted from October 2024 to March 2025 in the Department of Cardiology, Rehman Medical Institute Peshawar. Methodology: A total of 224 patients with STEMI were enrolled and divided into two groups: Group A (thrombolysed within 12 hours) and Group B (late presenters, not thrombolysed). Diagnosis was based on clinical symptoms, ECG criteria, and elevated troponin levels. In-hospital outcomes including mortality, left ventricular failure, mitral regurgitation, and ventricular septal rupture were documented. Results: Out of 224 patients, 122 received thrombolysis within 12 hours (thrombolysed group) and 102 presented late without thrombolysis (late presenters). The thrombolysed group had significantly lower mortality (9.8% vs. 25.5%; p=0.002), left ventricular failure (27.9% vs. 41.2%; p=0.036), ventricular septal rupture (4.9% vs. 13.7%; p=0.021), and mitral regurgitation (24.6% vs. 45.1%; p=0.001) compared to late presenters. Conclusion: Early thrombolysis in STEMI patients significantly improves in-hospital outcomes, emphasizing the importance of reducing delays in presentation and intervention.