Staff Members - Benha University
Fibrinolytic therapy in patients with ST-segment elevation myocardial infarction: Accelerated versus standard Streptokinase infusion regimen
• 2017
Publication Information
Authors
Ahmed Bendary*, Wael Tawfik, Mohammed Mahros, Mohamed Salem
Keywords
Myocardial Infarction
Streptokinase
Reperfusion
Journal
Not Available
Publisher
Not Available
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
International
Paper Link
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Supplementary Materials
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Abstract
Introduction: Timely fibrinolysis for acute ST-segment elevation myocardial infarction (STEMI)
reduces infarct size and hence preserves LV function and reduces mortality. Optimal regimen of
streptokinase (SK) infusion in such patients is a matter of interest. The current study aimed to
compare efficacy and safety of accelerated SK infusion regimen in patients with STEMI versus
the standard one.
Methods: One hundred consecutive STEMI patients were randomly allocated into one of 2 groups:
group I (50 patients) who received accelerated SK regimen (1.5 million units over 30 minutes)
and group II (50 patients) received standard SK regimen (1.5 million units over 60 minutes).
Efficacy was evaluated non-invasively using clinical (chest pain), ECG (resolution of ST segment)
and laboratory tests (earlier and higher peaking of cardiac troponin I). Safety was evaluated by
assessment of multiple in-hospital adverse events.
Results: Both groups were statistically matched in all baseline criteria. There was a significant
difference between both groups regarding each parameter of successful reperfusion in favor of
accelerated regimen. When all these parameters were combined, 31 patients (62%) had successful
reperfusion in group I versus 19 patients (38%) in group II (P = 0.016). We did not report any
significant difference between both groups regarding in-hospital mortality, in-hospital heart
failure, major bleeding, hypotension or allergic reaction to SK. Mean pre-discharge ejection
fraction was higher in group I than group II (50.9 ± 6.6% versus 47.3 ± 4.6%, P = 0.002).
Conclusion: Accelerated regimen of SK infusion is safe and effective method of reperfusion in
patients with STEMI.
reduces infarct size and hence preserves LV function and reduces mortality. Optimal regimen of
streptokinase (SK) infusion in such patients is a matter of interest. The current study aimed to
compare efficacy and safety of accelerated SK infusion regimen in patients with STEMI versus
the standard one.
Methods: One hundred consecutive STEMI patients were randomly allocated into one of 2 groups:
group I (50 patients) who received accelerated SK regimen (1.5 million units over 30 minutes)
and group II (50 patients) received standard SK regimen (1.5 million units over 60 minutes).
Efficacy was evaluated non-invasively using clinical (chest pain), ECG (resolution of ST segment)
and laboratory tests (earlier and higher peaking of cardiac troponin I). Safety was evaluated by
assessment of multiple in-hospital adverse events.
Results: Both groups were statistically matched in all baseline criteria. There was a significant
difference between both groups regarding each parameter of successful reperfusion in favor of
accelerated regimen. When all these parameters were combined, 31 patients (62%) had successful
reperfusion in group I versus 19 patients (38%) in group II (P = 0.016). We did not report any
significant difference between both groups regarding in-hospital mortality, in-hospital heart
failure, major bleeding, hypotension or allergic reaction to SK. Mean pre-discharge ejection
fraction was higher in group I than group II (50.9 ± 6.6% versus 47.3 ± 4.6%, P = 0.002).
Conclusion: Accelerated regimen of SK infusion is safe and effective method of reperfusion in
patients with STEMI.