Introduction: Hyperglycemia has a negative impact on morbidity and mortality among patients with acute myocardial infarction (AMI). Objective: The objective of the study was to evaluate the impact of chronic hyperglycemia on in-hospital and short-term outcome in patients with acute anterior MI treated with streptokinase as thrombolytic therapy. Materials and methods: A total of 100 patients with acute anterior myocardial infarction received streptokinase as thrombolytic therapy were enrolled. They were classified according to the admission glycated hemoglobin (HbA1c) level into two groups: Chronic hyperglycemic group (HbA1c ≥ 6.5%) (36 patients) and non-chronic hyperglycemic group (HbA1c <6.5%) (64 patients). Laboratory investigation, conventional echocardiography, and speckle tracking were performed. Results: Global longitudinal strain (GLS) was significantly lower in patients with chronic hyperglycemia group compared to non-chronic hyperglycemia group (−13.52 ± 4.83 vs. −15.27 ± 1.87%, p = 0.009). In-hospital outcome: Heart failure and reinfarction were significantly increased in patients with chronic hyperglycemia (45.5 vs. 16.7% and 18.2 vs. 3.3%, respectively, p < 0.05). Six months outcome: Heart failure, left ventricular (LV) remodeling, arrhythmias, and bleeding rates were significantly increased in patients with chronic hyperglycemia