The Effect of the Door to Needle Time of Streptokinase Administration on the Left Ventricular Function and Thrombolysis in Myocardial Infarction (TIMI) Flow Grade in Patients With Anterior Myocardial Infarction: A Single-Center, Prospective Follow-Up stud

Reza Ghasemi; Saeideh Imani Moghaddam; Fatemeh Ramezani; Mohsen Yaghubi

doi:10.18502/acta.v60i4.9267

Reza Ghasemi Department of Cardiology, 9 Dey Educational Hospital, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
Saeideh Imani Moghaddam Department of Critical Care, Razavi Hospital, Imam Reza International University, Mashhad, Iran
Fatemeh Ramezani Department of Critical Care, Razavi Hospital, Imam Reza International University, Mashhad, Iran
Mohsen Yaghubi Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran

DOI: https://doi.org/10.18502/acta.v60i4.9267

Keywords: Coronary angiography; Streptokinase; Ventricular ejection fractions

Abstract

Early administration of thrombolytic agents is the standard treatment and crucial for the outcome for patients presenting with acute myocardial infarction (MI). This study was conducted to evaluate the door to needle time of streptokinase administration and the left ventricular function in patients with anterior MI. This study was a prospective, single-center study on participants with anterior MI who were received streptokinase and non-streptokinase groups. After administration of streptokinase, QTc was measured in hyper-acute, acute, and recent phases of anterior MI in the case group and compared with acute and recent phases in the control group. The left ventricular function in 5 and 42 days after emergency department arrival was measured and compared in two groups. The data were analyzed by descriptive statistics method and variance analysis in the SPSS software, version 22. The level of significance was considered to be 0.05. Among 87 participants (45 streptokinases, 42 non-streptokinase), there was a significant relationship between the door to needle time in patients who received streptokinase in 1 hour (P=0.000), 3 hours (P=0.007), and 6 hours (P=0.016) after onset the chest pain and an ejection fraction of the patients in 5 days after hospitalization. Also, there was a significant relationship between ejection fraction in 5 days (P=0.000) and 42 days (P=0.000) of administration streptokinase and door to needle time. Reduction of the door to needle time after anterior MI has significant effects on QTc and incidence of threatening arrhythmia.