DOOR TO NEEDLE TIME OF STREPTOKINASE AND ST SEGMENT RESOLUTION ASSESSING THE EFFICACY OF REPERFUSION THERAPY AT KARACHI INSTITUTE OF HEART DISEASES
AbstractBackground: Early start of treatment including coronary revascularisation has been recognised ascrucial 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 thrombolytictherapy 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 withstreptokinase (SK) were enrolled in the study. Result: Of the total 1023, 689 (67.3%) patients weremales and 334 (32.6%) were females. Six hundred and twenty-nine (61.5%) were successfully resolvedafter thrombolytic therapy while in 395 (38.5%) patients ST-segment could not resolve into 3conventional ST-segment resolution categories at 60 minute and 90 minute after thrombolysis. Threehundred 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 minutesrespectively. Conclusion: Shock, congestive heart failure, and recurrent angina and ischemia occurredmore 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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