A Comparative Study to Assess the Efficacy of Streptokinase in Diabetic Versus Non-Diabetic Acute STElevation Myocardial Infarction Patients

Abstract

Objective: Prominent resolution in the ST segment elevation on electrocardiogram(ECG), thrombolysis at  the infarction site restoring perfusion determines the effectiveness of the streptokinase therapy. Hypercoagulable states and lack of efficacy with streptokinase is seen in diabetics. This study aimed to assess the  thrombolytic efficacy of streptokinase in diabetic vs non-diabetics patients.
Methods: A cross-sectional study was conducted at Cardiology Department of Allama Iqbal Memorial  Teaching Hospital, Sialkot from 1st September 2019 to 30th April, 2020. Total 504 patients of which 185  diabetics and 319 non-diabetic were selected. All the patients presenting with first episode of acute STelevation myocardial infarction were thrombolysed with 1.5million units of streptokinase within 12hours  from the onset of their typical chest pain symptoms. Acomplete record of ECG changes was kept before and
90 min after thrombolysis with streptokinase. Chi- square test was applied and p value <0.05 was considered significant.
Results: 89.19% diabetic patients had >70% resolution of ST segment changes in comparison to 95.61%  non-diabetics. 16.76% of the diabetic patients had increased ST-segment elevation post thrombolysis (Pvalue 0.001). 8.11% and 10.81% reinfarction rates during hospital stay and at one month post-thrombolysis  were recorded in diabetics. Reduced left ventricle Ejection Fraction was seen in 62.16% and 58.62% of the  diabetic and non-diabetic patients(P-value<0.005).
Conclusion: Comparatively decreased efficacy of streptokinase is seen in diabetic patients with reduced  resolution of ST-segment. In correspondence with reduced left ventricle EF, re-infarction and stroke  episodes.

How to Cite: Hassan Z., Rana N., Rana B., Iqbal I., Chughtai J.I. Acomparative study to assess the efficacy of  streptokinase in diabetic versus non-diabetic acute ST elevation myocardial infarction patients. Esculapio  2021;17(01).