Post-Therapy Outcome and Echocardiographic Analysis at Three Weeks of Elderly Patients With Acute Myocardial Infarction Following Thrombolysis

Abstract

BACKGROUND Once severe ischemia has lasted for about 20 minutes, myocardial necrosis ensues, affecting the subendocardium first and then proceeding in a time dependent wave front to reach epicardium about 4 to 6 hours later. Restoration of blood flow before necrosis is transmural, arrests the progression of necrosis and salvages the still viable but ischemic myocardium that would otherwise proceed to necrosis. We wanted to assess the occurrence of complications of half dose of streptokinase versus full dose of streptokinase in three weeks follow-up following thrombolysis therapy. METHODS Sixty elderly patients with acute myocardial infarction were enrolled in the study, presenting within 12 hours of onset of symptoms and having no contra-indication to thrombolytic therapy at GMC, Jammu for a period of one-year w.e.f. Nov. 2017 to Oct. 2018. RESULTS Out of the total 60 cases included in our study, 30 (50%) were assigned to the study group and 30 (50%) were included in the control group. Overall, 46 (76.7%) males and 14 (23.3%) females were included in the study. CONCLUSIONS Low dose streptokinase also achieved post-therapy outcome comparable to the standard dose, as assessed clinically and echocardiographically in a short-term follow-up of three weeks. Also, low dose streptokinase (7.5 lakh units) infusion was found to be associated with a lower incidence of haemorrhagic complications as compared to conventional full dose (1.5 million units) streptokinase infusion.