POST-THERAPY OUTCOME AND ECHOCARDIOGRAPHIC ANALYSIS AT THREE WEEKS OF ELDERLY PATIENTS WITH ACUTE MYOCARDIAL INFARCTION FOLLOWING THROMBOLYSIS
English

Vinod Kumar, Ritu Bhagat, Roopali Jandyal
2019 Journal of Evolution of Medical and Dental Sciences  
BACKGROUND Once severe ischemia has lasted for about 20 minutes, myocardial necrosis ensues, affecting the subendocardium first and then proceeding in a time dependent wave front to reach epicardium about 4 to 6 hours later. Restoration of blood flow before necrosis is transmural, arrests the progression of necrosis and salvages the still viable but ischemic myocardium that would otherwise proceed to necrosis. We wanted to assess the occurrence of complications of half dose of streptokinase
more » ... f streptokinase versus full dose of streptokinase in three weeks follow-up following thrombolysis therapy. METHODS Sixty elderly patients with acute myocardial infarction were enrolled in the study, presenting within 12 hours of onset of symptoms and having no contra-indication to thrombolytic therapy at GMC, Jammu for a period of one-year w.e.f. Nov. 2017 to Oct. 2018. RESULTS Out of the total 60 cases included in our study, 30 (50%) were assigned to the study group and 30 (50%) were included in the control group. Overall, 46 (76.7%) males and 14 (23.3%) females were included in the study. CONCLUSIONS Low dose streptokinase also achieved post-therapy outcome comparable to the standard dose, as assessed clinically and echocardiographically in a short-term follow-up of three weeks. Also, low dose streptokinase (7.5 lakh units) infusion was found to be associated with a lower incidence of haemorrhagic complications as compared to conventional full dose (1.5 million units) streptokinase infusion. KEY WORDS Acute Myocardial Infarction, Echocardiography, Post-Therapy Outcome HOW TO CITE THIS ARTICLE: Kumar V, Bhagat R, Jandyal R. Post-therapy outcome and echocardiographic analysis at three weeks of elderly patients with acute myocardial infarction following thrombolysis. BACKGROUND Acute myocardial infarction (AMI) has been found to be the leading cause of death in elderly over the age of 65 years. It accounts for 80% of deaths in the elderly, with 6.8% of the population of India over 60 years. The mortality in elderly is two-times more after AMI as compared to the younger counterparts. 1 The mortality of infarction increases very steeply with increasing age >65 years with 1-month mortality in the range of 20-30%. 2 Although early studies suggested an increased risk of haemorrhagic complications in the elderly patients receiving thrombolytic therapy, 3,4 large multicentric trials have shown that this fear is unfounded. 5,6 However, two recent studies have shown that streptokinase in conventional doses of 1.5 million units was associated with excess of strokes in patients aged more than 70 years. 7
doi:10.14260/jemds/2019/392 fatcat:lcb27mv2ejaprmmtsx452wztpu