COMPLICATIONS OF STREPTOKINASE IN PATIENTS WITH ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION: NO REASON TO WITHHOLD THIS EFFECTIVE THERAPY

Abstract

Objective: To determine the complications of Streptokinase in patients with acute ST segment elevation myocardial infarction (STEMI).

Methodology: This descriptive cross sectional study was conducted on 297 patients with acute STEMI enrolled with non-probability consecutive sampling. Patients were diagnosed with Third Universal Definition of Myocardial Infarction. Injection Streptokinase was administered as infusion according to the standard protocol after excluding contraindications. Every patient was continuously monitored for hemodynamic, allergic, electrical and fibrinolytic complications during infusion. Statistical Package for Social Sciences version 20 was used for data analysis. Logistic regression was used to test if low systolic blood pressure and heart rate at presentation are predictors of hypotension. Significance value was set at p <0.05.

Results: Mean age of the patients was 56.26 ±12.38 years. Male were 65.7%. Patients with history of hypertension, diabetes mellitus, past history of acute coronary syndrome, smoking and past history of streptokinase were 51.9%, 33.7%, 23.2%, 14.1% and 8.4%, respectively. Complications observed during Streptokinase infusion were; hypotension 6.7%, nausea and vomiting 6.4%; gums bleeding 3%, allergic reactions 3%, ventricular tachycardia 2.7%, ventricular fibrillation 2%, atrial fibrillation 2.4%, fever 2.4%, bradycardia 2%, hemoptysis 0.7% and intracranial hemorrhage 0.3% . Only one patient expired due to complications.

Conclusion: Significant hemodynamic and electrical complications during Streptokinase infusion in patients with ST segment elevation myocardial infarction were rare.