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Effect of streptokinase on reperfusion after acute myocardial infarction and its complications: an ex-post facto
Leila Taheri, Ali Zargham Boroujeni, Marzieh Kargar Jahromi
1Jahrom University of Medical Sciences, Jahrom, Iran. Charkhandaz@gmail.com.
Insights
Streptokinase (SK) improves reperfusion and ejection fraction (EF) in acute myocardial infarction patients but increases risks of arrhythmia and mortality. Further research comparing SK with tissue plasminogen activator is recommended.
Area of Science:
- Cardiology
- Pharmacology
- Emergency Medicine
Background:
- Acute myocardial infarction (AMI) requires prompt emergency treatment.
- Streptokinase (SK) is a primary clot-busting medication in Iran for AMI.
- SK aims to restore blood flow to ischemic heart tissue but carries significant risks.
Purpose of the Study:
- To evaluate the effect of Streptokinase (SK) on reperfusion in patients with AMI.
- To determine the complications associated with SK treatment in AMI patients.
Main Methods:
- An ex-post facto study involving 300 AMI patients.
- Two matched groups were analyzed based on age, sex, comorbidities, and infarct characteristics.
- Data collected via a validated questionnaire; analyzed using SPSS software.
Main Results:
- The Streptokinase (SK) group showed a higher mean ejection fraction (EF) compared to the control group (46.15±8.11 vs. 43.11±12.57).
- Significant associations were found between SK use and improved EF (p=0.020), reperfusion (p=0.028), and mortality (p=0.001).
- Ventricular tachycardia was the most common arrhythmia (20.7%) in the SK group; no significant link to pulmonary edema.
Conclusions:
- CCU nurses must be vigilant regarding SK complications like hypotension, bleeding, and arrhythmias.
- Clinical trials comparing Streptokinase (SK) with tissue plasminogen activator for reperfusion efficacy and safety are warranted.
Introduction:
Emergency treatment of patients with acute myocardial infarction is very important. Streptokinase in Iran is often as the only clot-busting medication is used. The purpose of using streptokinase medication is to revive the ischemic heart tissue, although has dangerous complications too. Therefore, the present study aimed to determine the effect of streptokinase on reperfusion after acute myocardial infarction and its complications, has been designed and conducted.
Materials & Methods:
This is an Ex-post facto study. The study population included patients who suffer from acute myocardial infarction. The sample size was 300 patients, and 2 groups were matched, in variables of age, sex, underlying disease, frequencies and area of MI. Data collection did by researcher making questionnaire, that accept face and content validity by 10 expert researcher, the reliability was conducted with Spearman's test (r=0.85) by Test-retest method. Data analysis did by SPSS software: V 12.
Findings:
Mean of EF in SK group was (46.15±8.11) and in control group was (43.11±12.57). Significant relationship was seen between SK, arrhythmia occurring and improve EF reperfusion by chi-square test (p=0.028), (p=0.020).The most arrhythmia in SK group was Ventricular Tachycardia (20.7%). Significant statistical relation between SK and mortality were found by Chi-square test (p=0.001). But a meaningful statistical relation was not found between SK and pulmonary edema incidence (p=0.071).
Conclusions:
Nurses of CCU should be aware about SK complications such as hypotension, bleeding and arrhythmias. Proposed compare SK and tissue plasminogen drug in reperfusion and complications effect.
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