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Streptokinase in acute myocardial infarction: a multicentric study in an Indian setting. Streptokinase Multicentric
Insights
Intravenous streptokinase is a safe and effective thrombolytic therapy for acute myocardial infarction in Indian hospitals. This multicentric study found lower mortality rates in patients who achieved reperfusion.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Acute myocardial infarction (AMI) remains a leading cause of mortality worldwide.
- Thrombolytic therapy is a critical treatment for AMI, aiming to restore blood flow.
- Evaluating the efficacy and safety of streptokinase in diverse healthcare settings is essential.
Purpose of the Study:
- To assess the benefits and complications of intravenous streptokinase therapy for AMI in Indian hospitals.
- To determine the impact of reperfusion on mortality in this patient population.
- To evaluate the safety profile of streptokinase in a multicentric Indian study.
Main Methods:
- A multicentric study involving 510 patients across 31 Indian hospitals.
- Intravenous administration of 1.5 million units of streptokinase within 8 hours of chest pain onset.
- Concurrent administration of aspirin (160 mg) and assessment of reperfusion by enzymatic criteria.
Main Results:
- Overall in-hospital mortality was 9.02% (46/510).
- Mortality was significantly lower in patients who achieved reperfusion (19/360) compared to those who did not (27/150).
- Complications associated with streptokinase were minor, with 95 reported incidents.
Conclusions:
- Intravenous thrombolysis with streptokinase is a safe and effective treatment for acute myocardial infarction in Indian hospitals.
- Achieving reperfusion is associated with reduced mortality in AMI patients treated with streptokinase.
- The study supports the use of streptokinase in diverse Indian healthcare settings for AMI management.
Abstract:
This paper presents the results of a multicentric study on the use of intravenous streptokinase as thrombolytic therapy in acute myocardial infarction. Its aim was to assess the benefits and complications of this therapy in Indian conditions. The study comprised 510 cases from 31 hospitals, employing a common protocol. 1.5 million units of streptokinase was given intravenously to all patients with acute myocardial infarction aged under 76 years, admitted within 8 hours of onset of chest pain. 160 mgms of aspirin was also administered. Use of other drugs was at the discretion of each centre. Parameters studied were reperfusion by enzymatic criteria, complications due to streptokinase and in-hospital mortality. There were 46 deaths overall (9.02%); mortality was lower in those who achieved reperfusion (19/360) as against those who did not (27/150). Complications due to streptokinase were all minor (95 incidents). It is concluded that intravenous thrombolysis with streptokinase in acute myocardial infarction is safe and effective in Indian hospitals of differing sophistication.