Coronary angiographic profi le in patients with failed thrombolysis

Saravanan, M.; Balakrishnan, Vinodkumar; Tr, Muralidharan

doi:10.17352/2455-2976.000095

Cited by 1 publication

(2 citation statements)

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“…Similarly, Sudhindra, et al, 8 and Samith M. Rafulah, et al, 9 found a substantial link between diabetes and the ST segment. 10 According to our findings, thrombolysis failure is influenced by the time it takes for thrombolysis to begin. These findings are supported by other studies, including those by Lee YY and others.…”

Section: Discussionmentioning

confidence: 66%

“…As a result, it's been found that using non-specific agents increases the risk of thrombolysis failing. 5 When it comes to infarct treatment, thrombolysis with streptokinase (fibrin nonspecific) is the most commonly used reperfusion strategy in countries like Pakistan. The patency rate of the coronary arteries is around 60% with recently available thrombolytic medications.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Post Thrombolytic Angiographic Profile and TIMI Flow in Patients with ST-Elevation Myocardial Infarction

Kumar¹,

Kakar²,

Shaikh³

et al. 2022

PJMHS

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Background: Myocardial infarction (MI) is the leading cause of morbidity and mortality worldwide. Primary Percutaneous coronary intervention (PPCI) is recommended as a treatment of choice in patients with STEMI but fibrinolysis also remains prevalent as a reperfusion strategy in most of the patients with STEMI presenting to non-PCI capable hospitals where timely PPCI cannot be performed. Objectives: To assess the angiographic characteristics and angiographic success of thrombolysis in terms of TIMI 3 flow in patients who underwent angiography after thrombolysis for STEMI and the factors most commonly associated with unsuccessful thrombolysis. Methods: All 130 hospitalized patients in the department of Cardiology, at Bolan Medical Complex Hospital, Quetta from 31st July 2021 to 30th November 2021 with an acute ST-segment elevation MI (STEMI) diagnosis who received thrombolytics were included in this observational study. We didn't include patients who couldn't benefit from thrombolysis e.g. NSTEMI, contraindication to thrombolytics, and refused fibrinolysis. A 12-lead electrocardiogram (ECG) was performed when the patient arrived in ER and a repeat ECG was done 90 minutes after the administration of a thrombolytic agent (streptokinase). To assess the angiographic success of thrombolysis, coronary anatomy, and TIMI flow, we performed coronary angiography in all patients included in this study. Results: The study included 130 patients, 72 of whom had successful thrombolysis and 58 who had unsuccessful thrombolysis. Angiography reported TIMI 3 flow rates of 48(36.9%). Subjects in the unsuccessful thrombolysis group had the single-vessel disease in 29 (50%) and a multi-vessel disease was found in 19 (32.75%) of the patients. Patients with successful thrombolysis had Single vessel disease 6 (19.3%), Multivessel disease 1 (3.2) It was observed that patients with diabetes mellitus had a significant rise in the number of failed thrombolysis compared to those without diabetes mellitus (p<0.005). It was also observed that anterior wall MI was significantly at risk for a failure in thrombolysis (82.1%) compared to inferior wall MI (17.8%). Conclusions: Effective thrombolysis was more prevalent than failed thrombolysis in our study. This data reiterates the utility of thrombolysis in resource-limited settings. Patients with diabetes, anterior wall MI, and delay in the presentations of the patients have a higher risk of thrombolysis failure. Type B lesions and multivessel disease were also prevalent in subjects with unsuccessful thrombolysis. According to the findings of this study, screening for risk factors before starting thrombolysis can aid in the development of alternative treatment methods that reduce failure rates and redirect resources to more successful treatment options. Keywords: Post thrombolytic; Angiographic Profile, TIMI flow; St-elevation; Myocardial Infarction

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%