Comparative analysis of type of myocardial infarction in patients with successful or unsuccessful streptokinase thrombolysis following ST elevation myocardial infarction.

OBJECTIVE: To study the effect of thrombolytic therapy in term of success and failure on the type of ST elevation MI, using streptokinase. MATERIAL AND METHODS: This was a comparative study, conducted at Department of Cardiology, Lady Reading Hospital, Peshawar, from October 2006 to October 2007. Patients with first acute myocardial infarction were divided into group A (successful thrombolysis) and group B (unsuccessful thrombolysis) using ECG criteria. RESULTS: Total number of patients were 200. Group A included 136 (68%) patients and group B included 64 (32%) patients. There were total 88 (44%) patients of anterior MI with 47 patients in group A and 41 patients in group B (34.6% vs 64.0%, p < 0.001). There were total 110 (55.0%) patients of inferior MI with 88 patients in group A and 22 patients in group B (64.7% vs 34.4%, p < 0.001). Lateral myocardial infarction was diagnosed in 2 (1%) patients with 1 patient each in group A and group B (0.7% vs 1.6%, p = 0.583). CONCLUSION: Anterior MI was associated with a higher rate of thromblysis failure while inferior MI and lateral wall MI was associated with a higher rate of successful thrombolysis.