Comparison of TIMI flow after Intravenous streptokinase vs Primary PCI in patients presenting with ST elevation Myocardial Infarction
Keywords:Primary PCI, streptokinase, acute MI, adverse outcomes, mortality, reinfarction rates
Background: Acute myocardial infarction (MI) relates to complete occlusion of a coronary artery because of the intraluminal thrombus which overlaps the atherosclerotic lesion. 500,000 patients with STEMI are diagnosed yearly in U.S. To restore the patency of the affected artery, two of the reperfusion therapies are thrombolytic therapy using streptokinase and the primary PCI. However, no agreement has been established between the studies to utilize one of them as treatment modality.
Objective: The study aims to compare intravenous streptokinase treatment with immediate angioplasty in patients with acute ST-elevation myocardial infarction.
Methodology: The study was a retrospective cohort conducted over a period of one year from July 2020 to June 2021. All the patients admitted consecutively during this period were chosen for either PCI group or streptokinase group. The study endpoints were successful reperfusion, TIMI flow grade 3 in the infarcted vessel at 24 hours and adverse outcomes.
Results: PCI was performed in 48 patients, which was successful for achieving final TIMI flow grade 2 or 3 in 46 (95.8%) patients and 66% patients who received SK were observed with TIMI 3 flow (P = 0.003). 2 patients (4 %) of the SK group were observed with TIMI flow grade 2. Median residual stenosis percentage was 82% (53 – 100) for SK and 21% (20 – 28) for PCI (P =0.0001). Adverse major outcomes were more frequently observed in SK group.
Conclusion: Primary PCI was found to provide better outcomes than streptokinase to treat acute MI and also to be associated with minimal in-hospital adverse outcomes including mortality and reinfarction rates.
Keywords: Primary PCI, streptokinase, acute MI, adverse outcomes, mortality, reinfarction rates.
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