RISK FACTORS ASSOCIATED WITH THE OCCURRENCE OF STREPTOKINASE INDUCED HYPOTENSION AMONG ST ELEVATION MYOCARDIAL PATIENTS (STEMI)

Abstract

Background: Hypotension is a common adverse drug reaction that occurs during Streptokinase (SK) infusion.
Despite this, there is paucity of data available to prevent and manage this reaction.
Objective: We conducted a study to determine the occurrence pattern and predict risk factors associated with this
reaction.
Setting: The study was conducted in a tertiary care hospital.
Methods: Data from 183 patients that were given SK for ST Elevations Myocardial Infarctions in 2018 and 2019
were retrieved.
Main outcome measure: Systolic Blood Pressure (SBP) measurements and corresponding durations during the
occurrence of this reaction were obtained.
Results: Hypotension was reported as the most common adverse drug reaction that occurred among 22.4% of
patients in the study. SK induced hypotension occurred at a median (IQR) of 15(13) minutes after starting SK
infusion. Hypotensive episode recovered in a median duration of 15(10) minutes with appropriate interventions.
Apart from temporarily withholding SK, most patients (58.5%) required a combination of fluid therapy and
vasopressor support to restore SBP. Although duration of SK infusion was prolonged in all patients (20.7 ± 13.5
minutes), interventions instituted were shown to be successful in restoring SBP. Patients with inferior MI were
shown to be a significant predictor for the occurrence of SK induced hypotension (OR =2.34; 95% CI = 1.16 –
4.74; p-value = 0.018).
Conclusion: The risk and benefit of administering SK to inferior MI patients must be assessed and effective
strategies can be implemented to ensure SK treatment is safe to all STEMI patients.