Enhanced thrombolytic efficacy and reduction of infarct size by simultaneous infusion of streptokinase and heparin

ABSTRACT

Thirty patients with recent onset acute myocardial infarction admitted to Coronary Care Unit of Ain Shams University Hospital. They divided into two groups. Group I patient received Simultaneous infusion of Streptokinase and heparin and group II patients received streptokinase followed by heparin two hours later. Group 1 showed signs of faster and shorter reperfusion time than group II, with rapid relief of chest pain and earlier peaking of serum creatinine phosphokinase enzyme with lower peak value. As well as rapid resolution of ECG criteria of ischemia and high incidence of reperfusion arrhythmia in group I than in group II. In the same time the segmental wall motion abnormalities were lower in group I than in group II and also the wall motion score index. Group I had better left ventricular function and higher ejection fraction than group II. Thus, the present study showed that simultaneous infusion of streptokinase and heparin early in acute myocardial infarction is better than subsequent infusion of heparin after streptokinase because the former resulted in more rapid recanalization of the infarct related artery, faster repefusion of the affected myocardium, smaller infarcts and better left ventricular function than the latter