EFFICACY OF STREPTOKINASE IN DIABETIC AND NON-DIABETIC PATIENTS PRESENTING WITH ACUTE ST ELEVATION MYOCARDIAL INFARCTION

Abstract

Objective: To determine the efficacy of streptokinase in diabetic versus nondiabetic patients presenting with acute ST Elevation Myocardial Infarction (STEMI). Methodology: This cross sectional study was conducted at Department of th Cardiology, Chaudry Pervaiz Elahi Institute of Cardiology, Multan from 16 th October 2012 to 15 April 2013. Patients with acute STEMI with in 12 hrs of chest pain without contraindications to fibrinolytic therapy (streptokinase) were included. ECG was done before and at 90 minutes after the start of streptokinase. ST-segment resolution equal to or more than 70% at 90 minutes ECG ,was taken in terms of successful reperfusion. The data was analyzed by using software SPSS version 10. The quantitative variables were presented as mean and standard deviation while qualitative variables as frequency and percentage. Chi square test was used to estimate significance and p-value of <0.05 was considered significant. Results: Out of 244 patients, 197(80.7%) were non-diabetics and 47(19.3%) were diabetics. Among the 47 diabetic patients ,streptokinase was effective in 16 patients and it was not effective in 31 patients .So efficacy of streptokinase in diabetic patients was 12.4% .Among the 197 non diabetic patients streptokinase was effective in 113 patients and not effective in 84 patients. The percentage showing effectiveness for streptokinase was 57.3% .Chi square test showed a pvalue less than 0.004 ,which shows a significant difference between efficacy of streptokinase among diabetic and non diabetic patients. Conclusion: This study shows that streptokinase was significantly more efficacious in non-diabetics as compare to diabetic patients presenting with acute STEMI.