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

Esculapio Pub Date : 2021-03-31 DOI:10.51273/ESC21.2517118

Zeeshan Hassan, N. Rana, B. Rana, A. Iqbal, Ali Javaid Chughtai

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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. Hyper- coagulable 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 ST- elevation myocardial infarction were thrombolysed with 1.5million units of streptokinase within 12hours from the onset of their typical chest pain symptoms. A complete 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 (P- value 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. Key Words: Streptokinase, acute myocardial infarction, STEMI, diabetes mellitus, hypercoagulability, atherosclerosis. How to Cite: Hassan Z., Rana N., Rana B., Iqbal I., Chughtai J.I. A comparative study to assess the efficacy of streptokinase in diabetic versus non-diabetic acute ST elevation myocardial infarction patients. Esculapio 2021;17(01):88-92

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链激酶治疗糖尿病和非糖尿病急性ST段抬高型心肌梗死疗效的比较研究

目的：心电图ST段抬高的显著消退、梗死部位溶栓恢复灌注决定了链激酶治疗的有效性。糖尿病患者出现高凝状态，链激酶缺乏疗效。本研究旨在评估链激酶对糖尿病和非糖尿病患者的溶栓疗效。方法：2019年9月1日至2020年4月30日，在锡亚尔科特Allama Iqbal纪念教学医院心内科进行横断面研究。共选择504名患者，其中185名糖尿病患者和319名非糖尿病患者。所有首次出现急性ST段抬高型心肌梗死的患者在出现典型胸痛症状后12小时内用150万单位链激酶进行血栓溶解。在链激酶溶栓前和溶栓后90分钟保存心电图变化的完整记录。应用卡方检验，与95.61%的非糖尿病患者相比，ST段变化的p值分辨率为70%。16.76%的糖尿病患者溶栓后ST段抬高（P值0.001），住院期间和溶栓后1个月的再梗死率分别为8.11%和10.81%。糖尿病和非糖尿病患者的左心室射血分数分别降低了62.16%和58.62%（P值<0.005）。结论：在ST段分辨率降低的糖尿病患者中，链激酶的疗效相对降低。与左心室EF降低、再梗死和中风发作相对应。关键词：链激酶，急性心肌梗死，STEMI，糖尿病，高凝状态，动脉粥样硬化。如何引用：Hassan Z.，Rana N.，Rana B.，Iqbal I.，Chughtai J.I.评估链激酶对糖尿病和非糖尿病急性ST段抬高型心肌梗死患者疗效的比较研究。Esculapio 2021；17（01）：88-92

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Esculapio

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12 weeks