ACUTE MYOCARDIAL INFARCTION

EFFECTS OF THROMBOLYSIS ON TIMI FLOW RATE IN INFARCT RELATED ARTERY (IRA) IN PATIENTS OF ST ELEVATED ACUTE MYOCARDIAL INFARCTION

Abstract

Objectives: To determine Post streptokinase TIMI flow grade (rate) in infarct
related artery (IRA) in ST elevated myocardial infarction patients. Study Design: A nonrandomized
prospective study. Period: Dec-2014 to Dec-2015. Setting: Sheikh Zayed Medical
College and Hospital Rahim Yaar Khan. Methods: 113 patients were selected to see post
streptokinase TIMI flow grade in infarct related artery (IRA). The data was analyzed using SPSS
Version 20. Descriptive statistics was used to see and analyze the data. Results: Mean age
of patients was 50.43±9.81 years. There was more males (87.61%) as compared to females
(12.39%). After thrombolyzation with streptokinase 23.01% patients were with TIMI grade 0/1
(failed perfusion), 45.13% (51) patients with TIMI grade 2 (partial perfusion) and 31.86% patients
with TIMI grade 3 (full perfusion) in infarct related artery. In our study TIMI flow improved to
grade 2/3 (partial to complete perfusion) in 76.99% patients. There were 11.73% patients with
TIMI 0/1 with 50% ST segment resolved, 8.85% patients with TIMI 0/1 with persisted 50% ST
segment, 32.74% patients with TIMI 2 with 50% ST segment resolved, 11.5% (13) patients with
TIMI 2 with 50% ST segment persisted, 32.74% patients with TIMI 3 with 50% ST segment
resolved and 4.42% patients with TIMI 3/1 with 50% ST segment persisted. Post streptokinase
there was no coronary artery thrombus in 91.07 % patients. While 6.25% patients had thrombus
in left coronary artery and 2.84% patients had right coronary artery thrombus. Conclusion:
Thrombolyzation with streptokinase improves perfusion in infarct related artery and increases
TIMI flow grade in STEMI patients. It reduces the risk of recurrent myocardial infarction by
restoration of blood flow in infarct related artery.