A Comparative Study of St Segment Resolution between Diabetic and Non-Diabetic ST Segment Elevation Myocardial Infarction Patients following Streptokinase Thrombolysis

Shahriar Iqbal, M Saiful Bari, MA Bari, Mirza Md Nazrul Islam, M Abdullah Al Shafi Majumder, Zahidul Islam, Gana Pati Aditya, Gobinda Kanti Paul, Shiblee Sadeque Shakil, Bishwanath Saha, Protap Kumar Paul, Mohammad Jalal Uddin

Background: One of the most effective and used (in our settings) methods of reperfusion of ST elevation
myocardial infarction (STEMI) is administration of streptokinase (SK) infusion. This study was conducted
with the aim to compare ST segment resolution between diabetic and non-diabetic patients with ST
segment elevation myocardial infarction after thrombolysis by streptokinase.
Methods: A total of 100 patients with ST elevation myocardial infarction with or without diabetes mellitus
were studied from December 2016 to November 2017. Among these half of patients were diabetic while
rests were non-diabetic. Streptokinase was administered to all patients. Resolution (reduction) of elevated
ST segment was evaluated after 90 min of streptokinase administration.
Results: Failed reperfusion (<30% ST resolution) was significantly higher in diabetic as compared to nondiabetic patients (42% vs. 12%, p <0.001). In hospital complications were more in diabetic patients who has
failed reperfusion following streptokinase thrombolysis. Cardiogenic shock occurred in 44% and acute
LVF in 30% patients and EF (46.54%) was significantly lower in diabetic patients and higher number of
diabetic patients had prolong hospital stay than non-diabetic patients with STEMI.
Conclusion: The outcome of thrombolytic therapy is adversely affected by diabetes mellitus in patients
with ST-elevation myocardial infarction.