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Streptokinase for acute myocardial infarction in the elderly
Insights
Streptokinase is a safe thrombolytic for elderly patients with acute myocardial infarction, with low rates of major bleeding and no intracranial hemorrhage. This finding supports its use in this population.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacology
Background:
- Acute myocardial infarction (AMI) is a leading cause of mortality in the elderly.
- Thrombolytic therapy use is lower in older adults due to concerns about complications like intracranial hemorrhage.
- This study addresses the safety of streptokinase in elderly AMI patients.
Purpose of the Study:
- To evaluate the safety of streptokinase, a common thrombolytic, in elderly patients diagnosed with acute myocardial infarction.
- To assess the incidence of complications associated with streptokinase administration in this demographic.
Main Methods:
- A descriptive case series of 100 elderly patients with AMI was conducted.
- Patients received streptokinase within 12 hours of symptom onset.
- Complications were monitored, including electrical, mechanical, and biochemical parameters.
Main Results:
- The study included 77% males and 23% females, with a mean age of 73.39 years.
- The most frequent complications were hypotension (33%) and bleeding (19%).
- Crucially, no intracranial hemorrhage occurred, and no deaths were attributed to streptokinase complications.
Conclusions:
- Streptokinase is a viable and safe treatment option for acute myocardial infarction in the elderly population.
- The benefits of streptokinase in elderly AMI patients outweigh the risks, particularly the feared intracranial hemorrhage.
- Clinicians should not hesitate to use streptokinase for acute myocardial infarction in elderly patients.
Background:
Acute myocardial infarction is one of the leading causes of death in the elderly, however clinical data reveals a disproportionately lower use of thrombolytics because of fear of complications especially intracranial haemorrhage. Our objective was to evaluate the safety of most commonly used thrombolytic streptokinase in elderly patients presenting with acute myocardial infarction.
Methods:
This descriptive case series was conducted at Punjab Institute of Cardiology, Lahore from September to December 2012 (4 months). One hundred elderly patients presenting with acute myocardial infarction were randomly selected for the study keeping in view the inclusion and exclusion criteria. All patients were thrombolysed with streptokinase within 12 hours of onset of symptoms and were monitored and investigated for electrical, mechanical and biochemical complications.
Results:
Out of one hundred patients 77 (77%) were males gnd 23 (23%) were females. Mean age was 73.39±5.29 years. The two most common complications of streptokinase were hypotension (33%) and bleeding (19%). Major bleed occurred only in 3 (3%) patients. No patient developed intracranial haemorrhage. Other complications included arrhythmias (6%), allergic reactions (4%), raised LFTs (6%) and raised RFTs (7%). No patient died of streptokinase related complications.
Conclusions:
Use of streptokinase for acute myocardial infarction should not be discouraged in the elderly.
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