DOOR TO NEEDLE TIME OF STREPTOKINASE AND ST SEGMENT RESOLUTION ASSESSING THE EFFICACY OF REPERFUSION THERAPY AT KARACHI INSTITUTE OF HEART DISEASES

Riffat Sultana, Nuzhat Sultana, Abdul Rasheed, Zahid Rasheed, Mansoor Ahmed, Muhammad Ishaq, Abdus Samad

Abstract


Background: Early start of treatment including coronary revascularisation has been recognised as
crucial variable in the outcome of acute ST-segment Elevation Myocardial Infarction (STEMI).
Objectives of the study were to determine the magnitude of ST-segment resolution after thrombolytic
therapy predicts short- and long-term outcomes in patients with an Acute Myocardial Infarction (AMI).
Methods: The duration of quasi experimental study was 3 years, from July 2006 to June 2009,
conducted at Karachi Institute of Heart Diseases. Total 1,023 patients of STEMI treated with
streptokinase (SK) were enrolled in the study. Result: Of the total 1023, 689 (67.3%) patients were
males and 334 (32.6%) were females. Six hundred and twenty-nine (61.5%) were successfully resolved
after thrombolytic therapy while in 395 (38.5%) patients ST-segment could not resolve into 3
conventional ST-segment resolution categories at 60 minute and 90 minute after thrombolysis. Three
hundred and twelve (30%) and 444 (43.4%) with complete resolution, 344 (33.62%) and 325 (31.76%)
with partial resolution, 367 (35.8%) and 491 (19.29%) were with no resolution at 60 and 90 minutes
respectively. Conclusion: Shock, congestive heart failure, and recurrent angina and ischemia occurred
more often in patientswith partial or no ST resolution as compare to complete resolution.
Keywords: myocardial infarction, thrombolysis, ST-segment elevation, congestive heart failure

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