Frequency of ST-segment resolution after thrombolysisin acute stelevation myocardial infarction patients

Background: Acute Coronary Syndrome (ACS) is the term collectively used for referring to clinical manifestations of myocardium ischemia which include unstable angina, myocardial infarction with non-ST-segment elevation and myocardial infarction with ST-segment elevation.1 Myocardial Infarction (STEMI) is characterized by ST elevation presented on the ECG, that is the electrical presentation of the occlusion due to thrombosis in a coronary artery. After the fibrinolytic therapy in STEMI cases, the resolution of ST-segment is analyzed on ECG which serves as easy and cost-effective solution for the assessment of coronary reperfusion. In a study, it is found that 61.5% patients of STEMI showed ST-resolution after streptokinase.   Aims and Objective: To determine the frequency of ST-segment resolution after streptokinase in acute STEMI patients.   Materials and Methods: This cross-sectional study was carried out from 08-07- 2016 to 07-01-2017.After taking approval from ethical committee and explaining the procedure informed consent was taken. Ninety-two (92) patients were recruited from emergency Department of Tabba Heart Institute Karachi on the basis of inclusion/exclusion criteria via non-probability consecutive sampling technique. ECGs were taken at presentation. ST-elevation was recorded in millimeters in lead with maximum ST-elevation. Injection streptokinase was administered. ECG was performed after 60 minutes of infusion of injection streptokinase. ST resolution in the lead with the maximum ST elevation was noted and was labeled as positive as per operational definition.   Results: The range of the age in this study was from 25 to 80 years with mean age of 54.9 ± 4.8 years. Out of 92 patients, 56(60.9%) were male and 36(39.1%) were female. Regarding ECG changes sixty patients (71.7%) were successfully resolved after streptokinase in acute STEMI patients while in twenty-six patients (28.3%) could not resolve.   Conclusion: Successfully resolution of ECG changes seen in 71.7% patients after streptokinase in acute STEMI patients while could not be resolved in 28.3% patients. Thus, streptokinase could be preferred therapy for thrombolysis in STEMI.   Keywords: ST-elevation myocardial infarction, streptokinase, ST- segment resolution.