Title: Incidence of Cardiogenic Shock in Acute Stemi Patients Thrombolysed with Streptokinse
Authors: Dr Uddhav Khaire, Dr Rahul Rathod, Dr Shweta Shinde
DOI: https://dx.doi.org/10.18535/jmscr/v8i2.51
Abstract
Introduction: Thrombolysis therapy in randomized controlled trials has shown to improve the natural history of acute myocardial infarction with approximate 30% reduction in mortality. Non-invasive detection of reperfusion is an useful guide for future management. Resolution of ST segment elevation following thrombolytic therapy has been shown to be a simple and useful predictor of left ventricular function and clinical outcome. Reduction in ST segment elevation, relief from chest pain, early peaking of serum concentration of creatine kinase and reperfusion arrhythmias are some of the non-invasive markers of reperfusion.1
Farrer M et al. suggested that previous studies have shown an association between each resolution of ST elevation after thrombolysis and improved coronary patency and clinical outcome.2 Thrombolytic therapy for acute myocardial infarction reduces case fatality and improves clinical outcomes.5,6
Material and Methods: We conducted cross sectional observational study in 200 patients of acute ST segment elevation myocardial infarction. Outcome of early (within 6 hours) and late (after 6 hours) thrombolysis in patients of STEMI studied and compared.
Results: About the complication after receiving thrombolytic therapy 37 % were in cardiogenic shock, 27.5 % land up in CCF, 15% showed arrhythmias. most of cases 85 (42.5 %)ST segment resolution > 50% were seen where there is initiation of therapy before 6 hours, whereas only 41 (20.5%) of cases shows improve ST segment > 50% after 6 hours of initiation of therapy.
Conclusion: Complication like cardiogenic shock were significantly less in patients thrombolysed within 6 hours of onset of chest pain compared to those who thrombolysed after 6 hours.
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