Title: Successful or Unsuccessful Thrombolysis with Streptokinase in Acute Myocardial Infarction: A Descriptive Study

Authors: Dr Rajiv Girdhar, Dr Yogesh Kothari, Dr Ram Anil Raj, Dr Prajwal Shastry, Dr Chaitra Kannadka, Dr Kumar Kenchappa, Dr Narayan Raju

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i3.122

Abstract

Background & Objectives: Acute myocardial infarction (AMI) is becoming increasingly important problem in developing countries, and thrombolysis is the main modality of treatment here. About 25-50% of patients fail to achieve successful reperfusion and these patients have poor prognosis. Since alternative modes of reperfusion are available, it is important to identify them. To study the effect of thrombolytic therapy in term of success and failure on the type of ST elevation MI, using streptokinase.

Material and Methods: This was a comparative study, conducted at Department of Cardiology, Rajarajeswari Medical College & Hospital Bangalore, from 1st October 2016 to31st November 2017. Patients with first acute myocardial infarction were divided into group A (successful thrombolysis) and group B (unsuccessful thrombolysis) using ECG criteria.

Results: Total number of patients were 104.Group A included 70 (67.30%) patients and group B included 34 (32.70%) patients. There were total 46(44.23%) patients of anterior MI with 24 patients in group A and 22 patients in group B (34.28% vs 64.70%, p<0.001). There were total 56 (53.84%) patients of inferior MI with 45 patients in group A and 11 patients in group B (64.28% vs 32.35%, p<0.001). Lateral myocardial infarction was diagnosed in 2 (1.9%) patients with 1 patient each in group A and group B (1.44% vs 2.9%, p=0.583).

Conclusion: Anterior MI was associated with a higher rate of thromblysis failure while inferior MI and lateral wall MI was associated with a higher rate of successful thrombolysis.

Keywords: Myocardial infarction; thrombolysis; type of myocardial infarction.

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