The Efficacy and Safety of Streptokinase in the Treatment of Patients with Acute Myocardial Infarction at Lumplaimat Hospital, Burirum Province
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Abstract
Objective: To study the efficacy and safety of streptokinase usage in patients with acute ST-segment elevation myocardial infarction at Lumplaimat hospital, Burirum province.
Setting: Lumplaimat hospital.
study design: Retrospective descriptive study
Subject: 5 patients in Lumplaimat Hospital who were diagnosed acute
Method: ST-segment elevation myocardial infarction and were treated with streptokinase during January 2006 to January 2007. : All patients who had acute ST-segment elevation myocardial infarction and were treated with streptokinase during January 2006 to January 2007 were assessed for survival rate at 7, 30 days after treatment, reinfarction rate and complication from streptokinase or other treatment. Age, sex, clinical presentation, duration of symptom before hospital arrival, Time from patiens arrival until administration of streptokinase, electrocardiographic result and serum troponin-T level also assessed in this study.
Results: Among 5 patients, there were 4 male and 1 female patients. Range of age was 49-73 years (mean 63 years). The clinical feature in most of the patients was chest pain and sweating (80°/o). The duration of symptoms before the patients came to the hospital was about 1-2 hours. The time from patients arrival to the hospital until administration of streptokinase was about 31-136 minutes. After fibrinolytic treatment, degree of ST-segment elevation decreased in all patients. The result showed that all 4 patients presented with chest pain before arrival survived at day 7 and 30 after treatment without acute cardiac complication and reinfarction. No complication from streptokinase found in these patients. Only 1 patient who had cardiac arrest and received cardiopulmonary resuscitation 8 minutes before given streptokinase death. Furthermore, upper gastrointestinal bleeding was found in this patient.
Conclusions: Fibrinolytic therapy such as streptokinase can be used in competent local hospitals. Streptokinase had good efficacy in increase survival rate and decrease reinfarction if patients came early and got early diagnosis. Appropriate patients selection led to safety in streptokinase usage.
Key words: Streptokinase, Acute myocardial infarction, survival, reinfarction.
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References
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