Abstract
Introduction: Once severe ischemia has lasted for about 20 minutes, myocardial necrosis ensues, affecting the subendocardium first and then proceeding in a time dependent wave front to reach epicardium about 4 to 6 hours later. Restoration of blood flow before necrosis is transmural, arrests the progression of necrosis and salvages the still viable but ischemic myocardium that would otherwise proceed to necrosis.
Aim: The objective is to assess the occurrence of complications of half dose of streptokinase versus full dose of streptokinase in three weeks follow-up following thrombolysis therapy.
Material and Methods: Sixty elderly patients with acute myocardial infarction were enrolled in the study, presenting within 12 hours of onset of symptoms and having no contra-indication to thrombolytic therapy at GMC, Jammu for a period of one year w.e.f nov.2017 to oct.2018.
Results: Out of the total 60 cases included in our study, 30 (50%) were assigned to the study group and 30 (50%) were included in the control group. Overall, 46 (76.7%) males and 14 (23.3%) females were included in the study.
Conclusion: In the present study, we conclude that low dose streptokinase also achieved post-therapy outcome comparable to the standard dose, as assessed clinically and echocardiographically in a short-term follow-up of three weeks.
Keywords: acute myocardial infarction, echocardiography, post-therapy outcome.
References
- Chopra KL. Thrombolytics and antithrombo-tics for acute coronary syndromes in the elderly. The Cardio Thoracic J 1996;2 (4):9-13.
- Sleight P. Is there an age limit for thrombolytic therapy? Am J Cardiol 1993; 72 (19) : 30G-33G.
- Aldrich MS, Sherman SA, Greenberg HS. Cerebrovascular complications of streptoki-nase infusion. JAMA 1958; 253 : 1777-1779.
- Lew AS, Hod H, Cercek B et Mortality and morbidity rates of patients older and younger than 75 years with acute myocardial infarction treated with intravenous streptokinase. Am J Cardiol 1987; 59 : 1-5.
- Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1986; 397-401.
- Muller DWM, Topol and Blood Institute. Morbidity and mortality chartbook on cardiovascular, lung and blood diseases, Bethesda. Md: US Department of Health and Human Services, Public Health Service, National Institute of Health; May 1992.
- Maggioni AP, Franzosi MG, Sanoro E et al. GISSI-2 and the International Study Risk of stroke in patients with acute myocardial infarction after thrombolytic and antithrombolytic treatment. N Engl J Med 1992; 327 : 1.
- Batterfield GB. Streptokiinase - a review of its pharmacology and therapeutic efficacy in acute myocardial infarction in older patients. Drugs Aging 1994; 4 (1) : 63-86.
- Ahmed, I. ECG and enzymatic indicators of therapeutic success after intravenous streptokinase for acute myocardial infarction - a pilot study. J Pak Med Ass 1992; 42 (12) : 288-290.
- Bose CC, Balkrishan S, Satyavarthy et Prospective study of safety and efficacy of 7.5 lakh units STK in AMI in Indian patients. Thrombolysis Update 1996; 4 (3) : 7-11.
- Sivan R, Chockalingam V, Subramanian T et al Comparative study of 7.5 lakh and 15 lakh units of streptokinase therapeutic issues in an elderly population with acute myocardial infarction. Indian Heart J 2003; 55 (5) : 149.
- Shah PK, Cercek B, Lew AS et al Angiographic validation of bedside markers of reperfusion. J Am Coll Cardiol 1993; 21 : 55. Sherry S, Alkajaersig N, Feather AP. Fibrinolysis and fibrinolytic activity in man. Physiol Rev 1959; 3:515.
- Hogg KT, Hornung RS, Howie CA et Electrocardiographic prediction of coronary artery patency after thrombolytic treatment in acute myocardial infarction: use of the ST segment as non-invasive marker. Br Heart 1988; 60 : 275-280.
- Gottlich C, Cooper B, Chumacher JR et al Do different doses of intravenous streptokinase after the frequency of coronary reperfusion in acute myocardial infarction? Am J Cardiol 1988; 62 : 843-846.
- Six AJ, Louwerenburg HW, Braams R et al A double-blind randomized multi-center dose-ranging trial of intravenous streptokinase in acute myocardial infarction. Cor Art Dis 1990; 65 (3) : 119-123
- White HD, Norris RM, Brown MA et Effect of intravenous streptokinase in left ventricular function and early survival after acute myocardial infarction. N EnglJMed 1987: 317 : 850-855.
Corresponding Author
Dr Ritu Bhagat
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