Document Detail

Streptokinase versus alteplase: comparison of echocardiographic parameters and post-coronarography treatment--our experience.
MedLine Citation:
PMID:  24601161     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Usage of fibrinolytic therapy leads to reperfusion of the occluded coronary arteries, rescue of ventricle myocardium and successful recovery of patient.
GOAL: The objective of this study was to compare the reperfusion effect of streptokinase and alteplase in acute myocardial infarction (AMI) by analyzing echocardiographic parameters and post-coronarography treatment.
PATIENTS AND METHODS: We observed 53 patients in AMI and divided them depending on applied therapy in streptokinase and alteplase group. Both groups were further divided into three subgroups depending on the time passed from chest pain occurrence to admission at Clinic. Observed echocardiographic parameters were: mitral regurgitation, left ventricular systolic and diastolic function and signs of ischemic cardiomyopathy. On coronary angiogram we analyzed severity of coronary artery disease as well as recommended treatment thereafter.
RESULTS: There were no significant difference in post-coronarography treatment, incidence and severity of mitral regurgitation and ischemic cardiomyopathy in alteplase vs streptokinase group- only significantly less diastolic dysfunction was noted in alteplase group (p=0.037). We noticed only significant difference when we took into consideration time from chest pain to admission at clinic. In alteplase first subgroup were more patients treated only with medications (without need for revascularization) vs streptokinase first subgroup (62,5% vs 28.6%, p=0.047). In alteplase first subgroup was lower incidence of mitral regurgitation (p =0.045), developed cardiomyopathy (p =0.009) and more preserved left ventricular diastolic function (p =0.008) compared to first streptokinase subgroup.
CONCLUSION: In our study we have found a significant difference between streptokinase and alteplase in echocardiographic parameters and post-coronarography treatment when we took into consideration time from occurrence of chest pain to admission at Clinic. The best outcomes had patients who were treated with alteplase within 1.5 hour from occurrence of chest pain.
Nerma Resic; Azra Durak-Nalbantic; Alen Dzubur; Enisa Hodzic; Mehmed Kulic; Nirvana Sabanovic-Bajramovic; Elmedina Jahic
Publication Detail:
Type:  Comparative Study; Journal Article; Observational Study    
Journal Detail:
Title:  Medical archives (Sarajevo, Bosnia and Herzegovina)     Volume:  67     ISSN:  0350-199X     ISO Abbreviation:  Med Arch     Publication Date:  2013  
Date Detail:
Created Date:  2014-03-07     Completed Date:  2014-04-17     Revised Date:  2014-07-07    
Medline Journal Info:
Nlm Unique ID:  101635337     Medline TA:  Med Arch     Country:  Bosnia and Hercegovina    
Other Details:
Languages:  eng     Pagination:  322-5     Citation Subset:  IM    
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MeSH Terms
Coronary Angiography
Fibrinolytic Agents / therapeutic use*
Middle Aged
Mitral Valve Insufficiency / drug therapy,  etiology,  ultrasonography
Myocardial Infarction / complications,  diagnosis,  drug therapy*
Retrospective Studies
Streptokinase / therapeutic use*
Time-to-Treatment / statistics & numerical data*
Tissue Plasminogen Activator / therapeutic use*
Treatment Outcome
Ventricular Dysfunction, Left / drug therapy,  etiology,  ultrasonography
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.-/Streptokinase; EC Plasminogen Activator

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