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.