Length of stay and major adverse cardiac events comparison between percutaneous coronary intervention and thrombolytic therapy in patients with ST-elevation myocardial infarction Ιmplications for cost effectiveness

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.