Abstract

The use of thrombolytic therapy in the treatment of acute myocardial infarction is widely accepted. Non-invasive methods for monitoring the reperfusion of the infarct related vessel include clinical markers, electrocardiography findings, and monitoring the specific cardiac proteins in plasma. Present study was aimed to study the usefulness of early changes in ST segment in predicting reperfusion occurring spontaneously or after thrombolysis in patients with AMI. Material and Methods: Present study was single-center, prospective, observational study, conducted patients of acute myocardial infarction (AMI) presenting within 12 hours of chest pain. All the patients received conventional therapy for AMI and those patients who were eligible for thrombolytic therapy received 7.5 lakh units of streptokinase (STK). Results: Out of 66 cases studied, 36 patients (54.54%) received thrombolytic therapy. The sudden relief of chest pain within 3 hours of initiating the treatment was observed in 28 patients (70%) in thrombolysed group and 12 patients (30%) in non thrombolysed group. The ST segment reduction of > 50% at 180 minutes was observed in 23 patients (63.88%) and 08 patients (26.66%) in the two groups respectively. Ten patients (27.77%) developed reperfusion arrhythmias in streptokinase group compared with 06 patients (20%) in non-streptokinase group. Significantly higher proportion of patients in streptokinase group achieved the criteria of reperfusion such as sudden relief of chest pain within three hours of initiating the treatment and >50% ST segment resolution at the end of 180 minutes (p <0.05). However, statistically significant difference was not observed when reperfusion arrhythmia was considered as a criteria of reperfusion between the two groups (p > 0.05). Conclusion: Using simple measurement of ST segment elevation, we were able to identify the high and the low-risk groups of patients as early as 60 minutes after initiating thrombolysis in the patients of AMI.

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