Failure of streptokinase therapy in diabetic and non-diabetic patients presenting with ST elevation myocardial infarction

Aim: to compare the frequency of failure of streptokinase therapy in diabetic versus non-diabetic patients presenting with st elevation myocardial infarction.methods: it was a cohort study of 100 cases. non probability purposive sampling method was used. patients between 30-70 years of either sex diagnosed with stemi presented within 12 hours of chest pain were divided into group a having diabetes and group b: having no diabetes. streptokinase was given to each patient within 1 hour of presentation. the sum of st-segment elevation was measured by hand held caliper at 80ms (two small squares) beyond j' point in leads 1,avl,v1to v6for lateral,leads ii,iii,avf for inferior and leads v1to v4for anteroseptal infarction. reperfusion was considered as failure if st resolution was <30% after 90 minutes of sk infusion.results: in diabetic patients mean st resolution was 35.01±18.29% with minimum and maximum of 6.25% and 77.30% respectively while in non diabetics mean st resolution was 60.33%±27.31%. with minimum and maximum of 3.60% and 100% respectively. in diabetic patients,reperfusion was unsuccessful in 21(42%) and in 29(58%) it was successful. in non-diabetic patients,it was unsuccessful in 6 (12%) while it was successful in 44(88%).conclusion: a significant proportion of diabetic patients did not achieve complete reperfusion within 90 min of starting thrombolytic therapy. © 2014 pakistan journal of medical and health sciences. all rights reserved.