Post Thrombolytic St-Segment Resolution Outcome in Acute Myocardial Infarction Patients
DOI:
https://doi.org/10.37762/jgmds.9-2.177Keywords:
Acute Myocardial Infarction, Thrombolysis, ST-segment Resolution, HospitalAbstract
OBJECTIVES:
The main objective of this study was to assess post thrombolytic resolution of ST-segment and its outcome in patients with acute myocardial infarction.
METHODOLOGY:
This Prospective Comparative Study was carried out at the Cardiology Unit of Ayub Teaching Hospital, Abbottabad. All patients irrespective of gender and age with ST-Segment elevation myocardial infarction (STEMI), having no immediate access to angioplasty and thrombolysed with streptokinase, were included in this study. ECG was taken at the beginning and 90 minutes after the administration of streptokinase. Based on ST-segment resolution on ECG taken at 90 minutes these patients were classified into group A and B. Group A included patients with ST-segment resolution while group B showed no resolution of ST-segment after streptokinase administration. These patients were followed during their hospital stay for complications such as arrhythmias, cardiogenic shock, acquired ventricular septal defects (VSD) aneurysm and death.
RESULTS:
Among 115 patients, 94 were male and 21 female. Group A included 102 (89%) patients and group B included 13 (11%). In group A, only 1 (0.98 %) patient developed complications and in group B, 13 patients (100%) developed complications. Arrhythmias were the most common complication among MI patients in group A while cardiogenic shock was the commonest complication in group B.
CONCLUSION:
ST-segment resolution is a practical and applicable indicator of successful thrombolysis and has a significant correlation with clinical outcome in acute myocardial patients after thrombolysis with streptokinase.
Downloads
Metrics
References
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-77
van Oosterhout RE, de Boer AR, Maas AH, Rutten FH, Bots ML, Peters SA. Sex differences in symptom presentation in acute coronary syndromes: a systematic review and meta‐analysis. J Am Heart Assoc. 2020;9(9):e014733
Vähätalo JH, Huikuri HV, Holmström LT, Kenttä TV, Haukilahti MA, Pakanen L, et al. Association of silent myocardial infarction and sudden cardiac death. JAMA Cardiol. 2019;4(8):796-802
Khan AA, Al-Omary MS, Collins NJ, Attia J, Boyle AJ. Natural history and prognostic implications of left ventricular end-diastolic pressure in reperfused ST-segment elevation myocardial infarction: an analysis of the thrombolysis in myocardial infarction (TIMI) II randomized controlled trial. BMC Cardiovasc Disord. 2021;21(1):1-9
Agrawal VV, Sarawag M. Prediction of ST elevation resolution on the basis of time interval of onset of chest pain to intervention (total ischemia duration) among AMI (acute myocardial infarction) patients undergoing PCI (percutaneous coronary intervention). J Dent Med Sci. 2019;18(6):7-17
Cahill TJ, Kharbanda RK. Heart failure after myocardial infarction in the era of primary percutaneous coronary intervention: mechanisms, incidence and identification of patients at risk. World J Cardiol. 2017;9(5):407
Dimitriu-Leen AC, Scholte AJ, Katsanos S, Hoogslag GE, van Rosendael AR, van Zwet EW, et al. Influence of myocardial ischemia extent on left ventricular global longitudinal strain in patients after ST-segment elevation myocardial infarction. Am J Cardiol. 2017;119(1):1-6
Aggarwal S, Xie F, High R, Pavlides G, Porter TR. Prevalence and predictive value of microvascular flow abnormalities after successful contemporary percutaneous coronary intervention in acute ST-segment elevation myocardial infarction. J Am Soc Echocardiogr. 2018;31(6):674-82
Tanabe K. Is there any impact of ST re-elevation on patients with acute myocardial infarction following reperfusion therapy?. Circ J. 2018;82(5):1249-50
Lindekleiv H, Berge E, Slot KM, Wardlaw JM. Percutaneous vascular interventions versus intravenous thrombolytic treatment for acute ischaemic stroke. Cochrane Database Syst Rev. 2018;10(10):CD009292
Gurbel PA, Tantry US. GEMINI-ACS-1: toward unearthing the antithrombotic therapy cornerstone for acute coronary syndromes. Lancet. 2017;389(10081):1773-5
Reed GW, Rossi JE, Cannon CP. Acute myocardial infarction. Lancet. 2017;389(10065):197-210.
Guo Z, Yang X. Does pre-angiography total ST-segment resolution reliably predict spontaneous reperfusion of the infarct-related artery in patients with acute myocardial infarction?. BMC Cardiovasc Disord. 2019;19(1):1-8
Rahuman MF, Jayawardena JB, Francis GR, Mahboob N, Kumara W, Wijesinghe A, et al. A comparison of rescue and primary percutaneous coronary interventions for acute ST elevation myocardial infarction. Indian Heart J. 2017;69(1):S57-62
Rashid M, Rushton CA, Kwok CS, Kinnaird T, Kontopantelis E, Olier I, et al. Impact of access site practice on clinical outcomes in patients undergoing percutaneous coronary intervention following thrombolysis for ST-segment elevation myocardial infarction in the United Kingdom: an insight from the British Cardiovascular Intervention Society Dataset. J Am Coll Cardiol Intv. 2017;10(22):2258-65
Bendary A, Tawfik W, Mahrous M, Salem M. Fibrinolytic therapy in patients with ST-segment elevation myocardial infarction: accelerated versus standard Streptokinase infusion regimen. J Cardiovasc Thorac Res. 2017;9(4):209
Iqbal S, Bari MS, Bari MA, Islam MM, Majumder MA, Islam Z, et al. A comparative study of ST segment resolution between diabetic and non-diabetic ST segment elevation myocardial infarction patients following streptokinase thrombolysis. Cardiovasc J. 2019;11(2):118-22
Ahmad M, Yasir M, Rahmat A. Acute ST elevation myocardial infarction: 70% or more ST segment resolution on 90 minutes post thrombolysis electrocardiogram as a predictor of in hospital outcomes. Prof Med J. 2018;25(5):777-83
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Aamir Ahmad, Syed Muhammad Adnan Shah, Raza Ullah, Syed Muhammad Salman Shah, Syed Mujeeb Ur Rahman, Muhammad Zuhaid
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
