Comparison of ST-segment resolution influencing in hospital outcome after primary percutaneous coronary intervention and fibrinolysis (with streptokinase) in patients with acute ST-segment elevation myocardial infarction

Authors

  • Md. Hasanur Rahman Assistant Professor, Department of Cardiology, Ibrahim Cardiac centre and Research Institution, Dhaka
  • Syeda Fahmida Afrin Associate Professor, Department of Biochemistry, Ibn Sina Medical College, Dhaka
  • Md. Aminul Islam Major, Army Medical Core, Bangladesh Army
  • Md. Saqif Shahriar Assistant Registar, National Institute of Cardiovascular Disease (NICVD), Dhaka
  • Md. Abu Zahid Consultant, Upazila Health Complex
  • Mohammad Badiuzzaman Professor Cardiology, National Heart Foundation Hospital & Research Institute (NHFH&RI), Dhaka

DOI:

https://doi.org/10.3329/bjms.v15i2.28794

Keywords:

ST-segment Elevation Myocardial Infarction, primary PCI, fibrinolysis, ST-resolution, outcome

Abstract

Background: Coronary artery disease (CAD) is the most common cause of mortality & morbidity in all over the world. Reperfusion therapy is the cornerstone for treating acute ST-segment elevation myocardial infarction. Effective reperfusion in STEMI can be achieved by either fibrinolysis or primary percutaneous coronary intervention (PPCI). PPCI generally produces better outcomes than fibrinolysis but is not widely available. ST-segment abnormalities play a fundamental role in assessment and decision making for patients with STEMI.

Methods: This quasi-experimental study was conducted in the Department of Cardiology, National Heart Foundation Hospital and Research Institute. Group I underwent primary PCI and group II received fibrinolytic therapy as reperfusion therapy for acute STEMI.

Results: The mean ST-segment resolutions were significantly more in group I than group II at 60 minutes (63.54±20.98 vs 33.97±15.88%, p<0.001) and at 90 minutes (73.15±18.76 vs 60.06±23.33%, p<0.015). However the difference is not significant at 180 minutes after procedure (74.48±18.09 vs 65.33±21.20%, p=0.064). In our study we observed that significantly higher number of patients of group II developed acute LVF (33.3% vs 6.1%, p=0.005) and cardiogenic shock (18.2% vs 3.0%, p=0.046) than group I and Rescue PCI was needed in 5 (15.2%% vs 0%, p=0.020) patients of group II than group I.

Conclusion: ST-segment resolution occurs earlier and more completely after Primary percutaneous coronary intervention than fibrinolysis (with Streptokinase) with better in hospital outcome in patients with acute STEMI.

Bangladesh Journal of Medical Science Vol.15(2) 2016 p.252-256

Downloads

Download data is not yet available.
Abstract
94
PDF
80

Downloads

Published

2016-08-10

How to Cite

Rahman, M. H., Afrin, S. F., Islam, M. A., Shahriar, M. S., Zahid, M. A., & Badiuzzaman, M. (2016). Comparison of ST-segment resolution influencing in hospital outcome after primary percutaneous coronary intervention and fibrinolysis (with streptokinase) in patients with acute ST-segment elevation myocardial infarction. Bangladesh Journal of Medical Science, 15(2), 252–256. https://doi.org/10.3329/bjms.v15i2.28794

Issue

Vol. 15 No. 2 (2016)

Section

Original Articles

License

Authors who publish in the Bangladesh Journal of Medical Science agree to the following terms that:

  1. Authors retain copyright and grant Bangladesh Journal of Medical Science the right of first publication of the work.

  2. Creative Commons Licence
    Articles in Bangladesh Journal of Medical Science are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.
  3. Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  4. Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.