A Study on Thrombolytic Effect of Streptokinase Infusion between Diabetic and Non-Diabetic Myocardial Infarction Patients with ECG as A Tool

Abstract

Introduction: A myocardial infarction (MI), commonly known as a heart attack, is the result of a sudden interruption in the blood flow to the heart muscle. This is frequently caused by a blood clot forming within the coronary arteries. Acute myocardial infarction (AMI) is a major health hazard that causes over a million deaths annually in the US and affects up to 3 million people globally. Thrombolytic therapy, such streptokinase, is used to break up blood clots and improve blood flow, which stops ischemia injury. Injectable streptokinase is used to activate plasminogen in a nonenzymatic manner.
Material And Method: This study examined thrombolytic outcomes in 120 patients with ST elevation myocardial infarction (STEMI) using a prospective interventional trial design. Patients were grouped according to gender and diabetes status. A thorough statistical analysis was carried out, looking at the relationship between gender and diabetes status and thrombolytic outcomes. Measurements such as glucose levels, ECG results, and random blood sugar were examined.
Result: There were notable differences in ST segment resolution between MI patients with diabetes and those without. Of the 70 diabetic MI patients, 61.42% had failed thrombolysis (less than 30% ST resolution), whereas 21.42% had successfully completed thrombolysis (more than 70% resolution) (p=0.003). Compared to diabetics, non-diabetic MI patients (n=50) had a greater success rate (44%) and a higher percentage of failed thrombolysis (24%; p=0.049). Anterior wall MI was more common in both groups, followed by inferior wall MI, while anteroseptal MI was less common. Men with diabetes (n = 45) demonstrated 23 failed, 10 partial, and 12 effective resolutions; women with diabetes (n = 25) demonstrated 11 failed, 9 partial, and 5 successful resolutions. Non-diabetic females (n=25) had only two instances of unsuccessful resolution, compared to three among non-diabetic males (n=25).
Conclusion: When comparing the thrombolytic effects of streptokinase, patients with diabetes had a higher incidence of unsuccessful thrombolysis (less than 30% ST resolution) than their non-diabetic counterparts. On the other hand, non-diabetic STEMI patients are
more likely to have effective thrombolysis (>70% ST resolution). This highlights the effect of type 2 diabetes on the results of thrombolysis. Given the documented difficulties in establishing successful thrombolysis in this subgroup, percutaneous coronary intervention may therefore be preferred to thrombolysis in diabetic STEMI cases.