THROMBOLYSIS WITH INTRAVENOUS STREPTOKINASE DOSE NOT ALTER 72-HOURS MORTALITY IN ACUTE MYOCARDIAL INFARCTION

Abstract

Objective: a) To find out mortality in Acute Myocardial Infarction within 72-hours treatment in coronary
care unit b) To compare mortality in Acute Myocardial Infarction treated with intravenous Heparin to that
of intravenous streptokinase. Design: Observational, retrospective study Setting: Coronary care unit of
Shaikh Zayed Postgraduate Medical Institute Lahore. Subject: Patient above >12 years of age, presenting
with acute myocardial infarction to Coronary Care Unit from 1.9.1989 to 31.8.1990 were included and their
mortality was compared with subsequent five years up to 31.8.1995. Intervention: Comparison of
intravenous Heparin 5000 units stat and 1000 units hourly infusion with 1,500,000 units of streptokinase
intravenous in 90 minutes in patients of Acute Myocardial Infarction along with other treatment given in
both groups. Main Outcome Measures: Death as a result of Acute Myocardial Infarction during 72-hours
stay at Coronary Care Unit. RESULTS: Baseline characteristics of two treatment groups were similar.
Mortality rate with IV Heparin alone in 1989-90 were 2.3% (95% Cl, 0.07-4.57). With intravenous
streptokinase in 1990-91 4.0% (Cl 1.28-6.7, P>0.05) in 1991-92 2.8% (CI 0.59-5.01, P>0.05) in 1992-93 2.7%
(Cl 0.09-5. 42, P>0.05) 1993-94 2.8% (Cl 0.59-8.54, P>0.05) in 1994-95 4.9% (Cl 1.37-8.54, P>0.05). The
mortality was slightly increased during 1991-92 but change was not significant P>0.05. There was fall in
mortality from 1993-95 again statistically insignificant P>0.05. CONCLUSION: Mortality rates in Acute
Myocardial Infarction remained same from 1989-90 to 1994-95. Thrombolysis with 1,500,000 units of
streptokinase in acute myocardial infarction did not make any difference in mortality as compared to
intravenous Heparin 5000 units stat and 1000 units/hourly within 72-hours of treatment at Coronary Care
Unit.