Frequency of Cardiac Arrhythmias Following Streptokinase Therapy in Patients Presenting with ST-Segment Elevation Myocardial Infarction: A Descriptive Case Series

Abstract

Objective: To determine the frequency of clinically significant cardiac arrhythmias observed following streptokinase therapy among patients presenting with ST-segment elevation myocardial infarction. Methodology: This descriptive case series was conducted at the Department of Cardiology, Khawaja Muhammad Safdar Medical College, Sialkot, from 20 November 2025 to 20 May 2026, after obtaining ethical approval (IRB No. 3/REC/KMSMC). A total of 100 consecutive patients aged 18–70 years with confirmed STEMI who received streptokinase within six hours of symptom onset were enrolled. Following thrombolytic therapy, all patients underwent continuous bedside cardiac monitoring for 72 hours, and clinically significant arrhythmias were documented using continuous monitoring and 12-lead electrocardiography. Results: The mean age of the participants was 52.18 ± 12.80 years, and the mean body mass index was 28.79 ± 5.69 kg/m². The study population comprised 67.0% males and 33.0% females. Diabetes mellitus, hypertension, dyslipidemia, and a family history of cardiovascular disease were present in 67.0%, 55.0%, 57.0%, and 60.0% of participants, respectively. Clinically significant cardiac arrhythmias were observed in 21.0% of patients during the first 72 hours following streptokinase administration. No statistically significant association was found between arrhythmia occurrence and age, gender, diabetes mellitus, hypertension, dyslipidemia, or family history of cardiovascular disease (p >0.05). Conclusion: Clinically significant cardiac arrhythmias were observed in approximately one-fifth of patients following streptokinase therapy for ST-segment elevation myocardial infarction. Owing to the descriptive design of the study, the findings describe the frequency of arrhythmias observed after thrombolytic therapy and should not be interpreted as evidence of a causal relationship between streptokinase administration and arrhythmia development.