Abstract
A prospective interventional study was carried out to compare the thrombolytic effect of streptokinase between diabetic and non-diabetic myocardial infarction patients. Out of 187 study subjects with acute ST segment elevation myocardial infarction (STEMI), admitted at coronary care unit, 126 patients were non-diabetic and 61 patients were diabetic. Streptokinase was administered to all patients. Resolution (reduction) of elevated ST segment was evaluated after 90 minutes of streptokinase administration. Successful reperfusion (?70% ST-resolution) was significantly higher in non-diabetic than diabetic (p<0.001), while failed reperfusion (<30% ST resolution) was significantly higher in diabetic patients (p<0.001). It may be concluded that diabetes mellitus might affect the thrombolytic outcome of acute myocardial infarction patients with diabetes mellitus.
Highlights
Acute myocardial infarction may be considered as a potential epidemic for mankind (WHO, 1982)
We evaluated the impact of type 2 diabetes in intravenous thrombolysis effectiveness by using a 12-lead ECG
There was significantly reduced ST-resolution observed in diabetic myocardial infarction patient (χ2= 40.7; p
Summary
Acute myocardial infarction may be considered as a potential epidemic for mankind (WHO, 1982). Incidence of coronary disease is increasing in Bangladesh (Khandaker et al, 1986). South Asians living in the UK and Canada do not display high rates of smoking, hypertension, or elevated cholesterol but still have higher rates of coronary artery disease compared with Europeans (Yusuf et al, 2001). Diabetes mellitus is one of the six primary risk factors identified for myocardial infarction, others are dyslipidemia, hypertension, smoking, male gender, and family history of atherosclerotic arterial disease. Diabetes is a dyslipidemic disease and increases the rate of atherosclerotic progression of vascular occlusion (Bajzer, 2002). Among patients with an acute myocardial infarction, 10-25% has diabetes (Mak et al, 1997). Even when promptly receiving thrombolytics the outcome in diabetic subjects is still worse than non-diabetics, manifesting impaired postthrombolysis left ventricular function and prognosis (Zairis et al, 2002)
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