A comparative study on the effect of streptokinase between diabetic and non-diabetic myocardial infarction patients

Authors

  • Md. Anup Rahman Chowdhury Department of Pharmacology, Sylhet M. A. G. Osmani Medical College, Sylhet 3100
  • A. K. M. Mosharrof Hossain Department of Pharmacology, Sylhet M. A. G. Osmani Medical College, Sylhet 3100
  • Sudhangshu Ranjan Dey Department of Cardiology, Sylhet M. A. G. Osmani Medical College Hospital, Sylhet 3100
  • A. K. M. Akhtaruzzaman Department of Cardiology, Sylhet M. A. G. Osmani Medical College Hospital, Sylhet 3100
  • Nur-A-Farhana Islam Department of Biochemistry, North East Medical College, Sylhet 3100

DOI:

https://doi.org/10.3329/bjp.v3i1.822

Keywords:

Diabetes mellitus, Myocardial infarction, Streptokinase

Abstract

A prospective interventional study was carried out to compare the thrombolytic effect of streptokinase between diabetic and non-diabetic myocardial infarction patients. Out of 187 study subjects with acute ST segment elevation myocardial infarction (STEMI), admitted at coronary care unit, 126 patients were non-diabetic and 61 patients were diabetic. Streptokinase was administered to all patients. Resolution (reduction) of elevated ST segment was evaluated after 90 minutes of streptokinase administration. Successful reperfusion (?70% ST-resolution) was significantly higher in non-diabetic than diabetic (p<0.001), while failed reperfusion (<30% ST resolution) was significantly higher in diabetic patients (p<0.001). It may be concluded that diabetes mellitus might affect the thrombolytic outcome of acute myocardial infarction patients with diabetes mellitus.

Downloads

Download data is not yet available.
Abstract
299
Download
161 Read
16

References

Angeja BG, De Lemos J, Murphy SA, Marble SJ, Antman EM, Cannon CP, et al. Thrombolysis in myocardial infarction: Impact of diabetes mellitus on epicardial and microvascular flow after fibrinolytic therapy. Am Heart J. 2002; 144: 649-56.

Bajzer CT. Acute myocardial infarction. In: Medicine index. Cleveland Clinic Foundation, 2002, pp 222-26.

Bassand JP, Danchin N, Filippatos G, Gitt A, Hamm C, Silber S, et al. Implantation of reperfusion therapy in acute myocardial infarction: A policy statement from the european society of cardiogy. Eur Heart J. 2005; 26: 2733-41.

Boon MA, Fox KAA, Bloomfield P. Bradbury A. Cardiovascular disease. In: Davidsons Principles and practice of medicine. Haslett C, Chilvers ER, Colledge NR (eds). 19th ed. London, Churchill Livingstone, 2002, pp 357-482.

Carley SD, Gamon R, Driscoll PA, Brown G, Wallman P. What's the point of ST elevation? Emerg Med J. 2002; 19: 126-28.

Hermentin P, Cuesta- Linker T, Weisse J, Heinz Schmidt K, Knorst M, Scheld M, et al. Comparative analysis of the activity and content of different streptokinase preparations. Eur Heart J. 2005; 26: 933-40.

Ishihara M, Sato H, Kawagoue T, Shimatani Y, Kurisu S, Nishioka K, et al. Impact of diabetes mellitus on long-term survival after acute myocardial infarction in patients with single vessel disease. Heart 2001; 86: 133-38.

Kenner MD, Zajec EJ, Kondos GT, Dave R, Winkelmann JW, Joftus J, et al. Ability of the no-reflow phenomenon during an acute myocardial infarction to predict left ventricular dysfunction at one month follow-up. Circulation 1995; 76: 861-68.

Khandaker RK, Hossain D, Hossain M, Zaman S. Retrospective analysis of acute myocardial infarction: A 4-year study of 2690 patients. Bangladesh Heart J. 1986; 1: 14-17.

McDonagh PF, Hokama JY, Copeland JG, Reynolds JM. The blood contribution to early myocardial reperfusion injury is amplified in diabetes. Diabetes 1997; 46: 1859-67.

Mahtab H, Khan AR, Latif ZA, Pathan F, Ahmed T. Guidelines for care of type 2 diabetes mellitus in Bangladesh. BIRDEM Clinical Research Group. 2003.

Mak KH, Moliterno DJ, Granger CB, Miller DP, White HD, Wilcox HD, et al. Influence of diabetes mellitus on clinical outcome in the thrombolytic era of acute myocardial infarction. J Am Coll Cardiol. 1997; 30: 171-79.

Maxwell S. Emergency management of acute myocardial infarction. Br J Clin Pharmacol. 1999; 48: 284.

Norhammar A, Malmberg K, Diderholm E, Lagerqvist B, Lindahl B, Ryden L, et al. Diabetes mellitus: The major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization. J Am Coll Cardiol. 2004; 43: 585-91.

Sabatine MS, Cannon CP, Gibson CM, Lopez-sendon JL, Montalescot G, Theroux P, et al. Addition of clopidegrol to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. New Engl J Med. 2005; 352: 1179- 89.

Purcell IF, Newell N, Farrer M. Change in ST segment elevation 60 minutes after thrombolytic initiation predicts clinical outcome as accurately as later electrocardiographic changes. Heart 1997; 78: 465-71.

Schroder R, Dissmann R, Bruggemann T, Wegscheider K, Linderer T, Tebbe U, et al. Extent of early ST segment elevation resolution: A simple but strong predictor of outcome in patients with acute myocardial infarction. J Am Coll Cardiol. 1994; 24: 384- 91.

Thiele H, Engelmann L, Elsner K, Kappl MJ, Storch WH, Rahimi K, et al. Comparison of pre-hospital combination- fibrinolysis plus facilitated percutaneous coronary intervention in acute myocardial infarction . Eur Heart J. 2005; 26: 1956-63.

Van tHof AW, Liem A, de Boer MJ, Zijlstra F. Clinical value of 12 lead electrocardiogram after successful reperfusion therapy for acute myocardial infarction: Zwolle Myocardial Infarction Study Group. Circulation. 1997; 350: 615-19.

WHO Expert Committee. Prevention of coronary heart diseases. WHO Technical report. 1982, Series No. 678.

Woodfield SL, Lundergan CF, Reiner JS, Greenhouse SW, Thompson MA, Rohrbeck SC, et al. Angiographic findings and outcome in diabetic patients treated with thrombolytic therapy for acute myocardial infarction: The GUSTO-I experience. J Am Coll Cardiol. 1996; 28: 1661-69.

Yuling F, Goodman S, Chang WC, Van de Werf F, Granger CB, Armstrong PW. Time to treatment influences the impact of ST-segment resolution on one-year prognosis: Insights from the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT-2) trial. Circulation 2001; 104: 2653-59.

Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 2001; 104: 2855-64.

Zairis MN, Lyrus AG, Makrygiannis SS, Psarogianni PK, Adamopoulou EN, Handanis SM. Type 2 diabetes and intravenous thrombolysis outcome in the setting of ST elevation myocardial infarction. Diabetes Care. 2004; 27: 967-71.

Zairis MN, Makrygiannis SS, Papadaki OA, Lyras AG, Kouzanidis JP, Ampartzidou OS, et al. Diabetes and ST elevation myocardial infarction. Diabetes Care. 2002; 25: 1890-91.

Zeymer U, Schröder R, Tebbe U, Molhoek GP, Wegscheider K, Neuhaus KL. Non-invasive detection of early infarct vessel patency by resolution of ST-segment elevation in patients with thrombolysis for acute myocardial infarction: Results of the angiographic substudy of the Hirudin for Improvement of Thrombolysis (HIT)-4 trial. Eur Heart J. 2001; 22: 769-75.

Downloads

Additional Files

Published

2008-04-20

How to Cite

Chowdhury, M. A. R., A. K. M. M. Hossain, S. R. Dey, A. K. M. Akhtaruzzaman, and N.-A.-F. Islam. “A Comparative Study on the Effect of Streptokinase Between Diabetic and Non-Diabetic Myocardial Infarction Patients”. Bangladesh Journal of Pharmacology, vol. 3, no. 1, Apr. 2008, pp. 1-7, doi:10.3329/bjp.v3i1.822.

Issue

Vol. 3 No. 1 (2008)

Section

Research Articles

License

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive 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.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).