scholarly journals Clinical profile of ST-elevation myocardial infarction thrombolysed with tenecteplase in Coronavirus Disease 2019 Pandemic: A comparative study

2021 ◽  
Vol 10 (2) ◽  
pp. 58
Author(s):  
KamalKant Jena ◽  
G Manohar ◽  
C Elamaran ◽  
A Rudrappa
2021 ◽  
Vol 18 (1) ◽  
pp. 33-37
Author(s):  
Pradeep Thapa ◽  
Prakash Aryal ◽  
Rajani Baniya

Background and Aims: ST-Elevation Myocardial Infarction (STEMI) is a leading cause of morbidity and mortality. This study aims to summarize the clinical profile and complications of patients with STEMI in a teaching hospital. Methods: This was a prospective hospital based descriptive and observational study conducted at College of Medical Sciences Teaching Hospital (CoMSTH), Bharatpur from January 2017 to July 2018 in 110 patients with a diagnosis of acute STEMI. Results: Out of 110 patients the mean age of presentation was 59.31 years and 64.5% were male. Typical chest pain (90%) was the most common presenting symptom and 45.5% patients presented within six hours of chest pain. Most common traditional risk factors were hypertension and smoking which were present in 44 (40%) cases, followed by diabetes in 33 (30%), dyslipidemia in 22 (20%). Majority of patients (49.1%) were in killips class I, and only 9 (8.2%) patients were in cardiogenic shock (killips class IV). Inferior wall was the most common in 30% patients followed by anteroseptal wall MI (23.6%), anterior wall MI (11.8%) and combined (anterior and inferior) in 10%. Revascularization with primary Percutaneous Coronary Intervention (PCI) was done in 46 (41.8%) patients, thrombolysis was done in 41 (37.3%) patients. Arrhythmias (39.1%) followed by heart failure (24.5%) were the common complications. The overall in-hospital mortality was 16 (14.5%). Conclusions: Patients with acute STEMI at College of Medical Sciences Teaching Hospital (CoMSTH) were predominantly male with hypertension and smoking as the commonest risk factors. Arrhythmias were the most common complications and in-hospital mortality rate was 14.5%.


Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 88-92
Author(s):  
Zeeshan Hassan ◽  
Nabeegh Rana ◽  
Bakhtawar Rana ◽  
Asif Iqbal ◽  
Ali Javaid Chughtai

Objective: Prominent resolution in the ST segment elevation on electrocardiogram(ECG), thrombolysis at the infarction site restoring perfusion determines the effectiveness of the streptokinase therapy. Hyper- coagulable states and lack of efficacy with streptokinase is seen in diabetics. This study aimed to assess the thrombolytic efficacy of streptokinase in diabetic vs non-diabetics patients. Methods: A cross-sectional study was conducted at Cardiology Department of Allama Iqbal Memorial Teaching Hospital, Sialkot from 1st September 2019 to 30th April, 2020. Total 504 patients of which 185 diabetics and 319 non-diabetic were selected. All the patients presenting with first episode of acute ST- elevation myocardial infarction were thrombolysed with 1.5million units of streptokinase within 12hours from the onset of their typical chest pain symptoms. A complete record of ECG changes was kept before and 90 min after thrombolysis with streptokinase. Chi- square test was applied and p value <0.05 was considered significant. Results: 89.19% diabetic patients had >70% resolution of ST segment changes in comparison to 95.61% non-diabetics. 16.76% of the diabetic patients had increased ST-segment elevation post thrombolysis (P- value 0.001). 8.11% and 10.81% reinfarction rates during hospital stay and at one month post-thrombolysis were recorded in diabetics. Reduced left ventricle Ejection Fraction was seen in 62.16% and 58.62% of the diabetic and non-diabetic patients(P-value<0.005). Conclusion: Comparatively decreased efficacy of streptokinase is seen in diabetic patients with reduced resolution of ST-segment. In correspondence with reduced left ventricle EF, re-infarction and stroke episodes. Key Words: Streptokinase, acute myocardial infarction, STEMI, diabetes mellitus, hypercoagulability, atherosclerosis. How to Cite: Hassan Z., Rana N., Rana B., Iqbal I., Chughtai J.I. A comparative study to assess the efficacy of streptokinase in diabetic versus non-diabetic acute ST elevation myocardial infarction patients. Esculapio 2021;17(01):88-92


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