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

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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

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