Sher Bahadar Khan, Rafiullah Rafiullah, Lubna Noor, Khurshid Ahmad, Yasir Adnan, Amber Ashraf, Asif Iqbal, Hafiz ur Rehman, Mohammad Hafizullah


Objective: 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, Lady Reading Hospital, Peshawar, from October 2006 to October 2007.
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 200.
Group A included 136 (68%) patients and group B included 64 (32%) patients. There were total 88
(44%) patients of anterior MI with 47 patients in group A and 41 patients in group B (34.6% vs 64.0%,
p<0.001). There were total 110 (55.0%) patients of inferior MI with 88 patients in group A and 22
patients in group B (64.7% vs 34.4%, p<0.001). Lateral myocardial infarction was diagnosed in 2 (1%)
patients with 1 patient each in group A and group B (0.7% vs 1.6%, 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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Gruppo Italiano per lo Studio della Streptochinasi nell’Infarto

Miocardico (GISSI). Effectiveness of intravenous thrombolytic

treatment in acute myocardial infarction. Lancet 1986;1:397–402.

ISIS-2 (Second International Study of Infarct Survival)

Collaborative Group. Randomised trial of intravenous

streptokinase, oral aspirin, both, or neither among 17,187 cases of

J Ayub Med Coll Abbottabad 2012;24(1)

suspected acute myocardial infarction: ISIS-2. Lancet


De Belder MA. Coronary disease: acute myocardial infarction:

unsuccessful thrombolysis. Heart 2001;85:104–12.

Group FTTFC. Indications for fibrinolytic therapy in suspected

acute myocardial infarction: collaborative overview of early

mortality and major morbidity results from all randomised trials

of more than 1,000 patients. Lancet 1994;343:311–22.

Sutton AG, Campbell PG, Price DJ. Failure of thrombolysis by

streptokinase: detection with a simple electrocardiographic

method. Heart 2000;84:149–56.

Ahmad S, Qureshi MBA, Abbas MZ, Chaudhry MK, Ghani

MU. A comparative study of complications in patients of

myocardial infarction managed with and without streptokinase.

Pak J Cardiol 2004;15:61–7.

Topol EJ. Acute myocardial infarction:thrombolysis. A current

overview of the benefits and limitations of thrombolytic strategies

and the move towards combining thrombolytic agents with

glycoprotein IIb/IIIa receptor blockers. Heart 2000;83:122–6.

Hochman JS, Sleeper LA, White HD. One-year survival following

early revascularization for cardiogenic shock. JAMA


Bhatia L, Clesham GJ, Turner DR. Clinical implications of STsegment non-resolution after thrombolysis for myocardial

infarction. J R Soc Med 2004;97:566–70.

Henriques JPS, Zijlstra F, Van’t Hof AW. Primary percutaneous

coronary intervention versus thrombolytic treatment: long term

follow up according to infarct location. Heart 2006;92:75–9.

Prendergast BD, Shandall A, Buchalter MB. What do we do

when thrombolysis fails? A United Kingdom survey. Int J

Cardiol 1997;61:39–42.

An international randomized trial comparing four thrombolytic

strategies for acute myocardial infarction. The GUSTO

investigators. N Eng J Med 1993;329:673–82.

Lee YY, Tee MH, Zurkurnai Y, Than W, Sapawi M, Suhairi I.

Thrombolytic failure with streptokinase in acute myocardial

infarction using electrocardiogram criteria. Singapore Med J


Goldhammer E, Kharash L, Abinader EG. Circadian fluctuations

in the efficacy of thrombolysis with streptokinase. Postgrad Med

J 1999;75:667–71.

Brener SJ, Ellis SG, Sapp SK. Predictors of death and

reinfarction at 30 days after primary angioplasty: the GUSTO IIb

and RAPPORT trials. Am Heart J 2000;139:476–81.

Schröder R, Wegscheider K, Schröder K, Dissmann R, MeyerSabellek W. Extent of early ST segment elevation resolution: a

strong predictor of outcome in patients with acute myocardial

infarction and a sensitive measure to compare thrombolytic

regimens. A substudy of the International Joint Efficacy

Comparison of Thrombolytics (INJECT) trial. J Am Coll Cardiol


Schroder R, Zeymer U, Wegscheider K, Neuhaus KL, for the

HIT-4 Trial Group. A substudy of the Hirudin for Improvement

of Thrombolysis (HIT)-4 Study. Comparison of the predictive

value of ST segment elevation resolution at 90 and 180 min after

start of streptokinase in acute myocardial infarction. Eur Heart J



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