Abstract
The study aims to identify factors that affect the door-to-needle time for fibrinolytic therapy in patients
with acute myocardial infarction in Buengkan hospital. A retrospective review of medical records
from October 2554 to October 2555 was conducted of all patients receiving thrombolytics for AMI. A total
of 37 patients with acute ST elevation myocardial infarction (STEMI) were identified. Median door-toneedle
time achieved was 30 minutes (range 10 - 180mins). A door-to-needle time of 30 minutes or less
was achieved in 22 (59%) patients. The predominant infarct location on EKG was anterior (35%). The three
factors that can affect door-to-needle time were evaluated: office hours, symptoms and use of care map.
Although the study found no statistical difference in the three factors, the percentage of patients whose
door-to-needle time within 30 minutes was achieved rose among those who came outside of office hours,
presented with typical symptoms, and after the implementation of the STEMI care map, (68, 60.6, and 63
percent, respectively). After implementation, the mean door-to-needle time did not decrease, but the
number of patients whose door-to needle-time within 30 minutes was achieved increased from 50% to
63%. Creating a STEMI network in Buengkan Province could decrease the onset-to-needle time.
