EFFICACY OF STREPTOKINASE IN DIABETIC PATIENTS WITH ACUTE ST ELEVATION MYOCARDIAL INFARCTION

Abstract

Introduction: After sudden cardiac death (ACS), ST-segment elevation myocardial infarction (STEMI) is the most severe form of acute coronary syndrome (ACS). The coronary artery disease is much more serious in diabetics with 4 times higher morbidity/mortality in men, while 8 times in women. Patients with diabetes mellitus who presented with acute STEMI often have a higher risk of adverse outcomes than non-diabetic counterparts, probably due to extensive coronary disease or poor left ventricular function. The outcome of AMI treated with fibrinolytic therapy Methodology: This was a descriptional cross sectional study carried out at the cardiology department of Ayub Teaching Hospital from June 2015 to July 2016. Total of 169 patients with STEMI were included in the study using non-probability consecutive sampling. Patients were administered injection Streptokinase in a dose of 1.5 million units, diluted in 100 ml of normal saline, in 1 hour and repeat ECG was done at 90 mins to assess ST segment resolution. Results: Mean age of the patients was 53.76±4.76 years. Most of the patients were >55 years of age. Out of 169 patients, 69.23% (n=117) were male patients while 30.77% (n=52) were female. Streptokinase administration in acute STEMI in diabetics revealed ST segment resolution at 90 mins in 15.38%(n=26) while 84.62%(n=143) showed no ST segment resolution. Conclusion: The study reveals that thrombolytic therapy is not effective in diabetic subjects with STEMI. In diabetics to improve outcome, newer strategies such as peri-infarction metabolic control and primary angioplasty should be investigated.

Pak J Physiol 2019;15(1):10-2