Shafique Ahmed, Muhammad Bilal Ahsan Qureshi, Muhammad Zafar Abbas, Mohammed Kashif Chaudhry, Muhammad Usman Ghani.
A comparative study of complications in patients of Myocardial Infarction managed with and without Streptokinase.
Pak J Cardiol Jan ;15(2):61-7.

Background - Numerous meta-analysis have been published and on the basis of the results of the some or all of the more than 33 trials evaluating intravenous streptokinase for acute myocardial infarction. All of these reviews demonstrated a consistent, statistically significant reduction in mortality for patients with acute myocardial infarction who were treated with intravenous streptokinase. Objectives - Intravenous streptokinase clearly confers a protective effect against early mortality in patients with acute myocardial infarction, with this initial hope that the administration of thrombolytics to patients with evolving acute myocardial infarction will prevent infarct complications. We conducted prospective study to observe the rate of complications as a whole in patients who could not get the thrombolytic therapy. Setting - This study was conducted in the coronary care unit and out patient Department of Cardiology Bahawal Victoria hospital Bahawalpur affiliated with Quaid-e-Azam Medical College Bahawalpur. Methods - This observational study was carried out in 960 patients fulfilling the diagnostic criteria for acute myocardial infarction. These patients were prospectively followed for clinical end points during the hospitalization and 90 days follow up period. Streptokinase 1.5 million units was used as a thrombolytic agent in the patients fulfilling the eligibility criteria. Results - A total of 960(21.22%) patients with acute myocardial infarction were assessed for the complications of myocardial infarction with or without thrombolytic therapy. Male and female patients were 664 (69.16%) and 296(30.83%) respectively. Mean age of patients with myocardial infarction was 57.30 years. Anterior myocardial infarction was diagnosed in 680(70.83%) patients and inferior wall myocardial infarction was diagnosed in 280(29.16%) patients. Streptokinase was given in 500(52.08%) patients while 460(47.9%) did not get it. There was statistical significant difference of complications as a whole with p value of < 0.001. Conclusion - Thrombolysis is the first line between life and death and now it has become the established fact beyond doubt in the treatment of acute myocardial infarction. The advent of streptokinase has led to substantial changes in clinical practice of managing acute myocardial infarction especially evolving one. The magnitude of the treatment effect lowers the risk of mortality and hospital stay.

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