[Influence of various factors on Response to Streptokinase therapy for acute myocardial Infarction]

ABSTRACT

Prevalence of ischemic heart diseases, especially acute myocardial infarction and its incidence in lower age has increased and treatment during the acute phase of myocardial infarction plays an important role in the prognosis and quality of life. In our study, we aimed to evaluate the effects of streptokinase on treatment of acute myocardial infarction based on different variables. In our study, we evaluated patients with acute myocardial infarction who received streptokinase. Information obtained from patients based on patient examination, ECG findings [before and after drug administration] and the results of relevant laboratory tests, then entered in the relevant checklist. Criteria for response to drug were reduced chest pain with at least 50 percent reduction in ECG ST Elevation in electrocardiography taken 30 or 90 minutes after the Streptokinase therapy. Relation between age [P<0.001], LDL [0.001], diabetes mellitus [P=0. 01], location of MI [P=0.001], Killip Class [P<0.001], patients referring delay [P<0.001] and the effect of streptokinase were significant. While gender, hypertension, smoking, previous ischemic heart disease, time of symptoms onset and type of streptokinase didn't affect significantly the response to streptokinase. Considering our results, patients with acute MI less than 30 years and more than 80 years, diabetics, LDL more than 100mg/dl, extensive anterior MI, new LBBB, Killip Class 3 or 4 and delay of referring more than 12 hours predict poor response streptokinase, and may benefit more from early invasive strategy than thrombotic therapy