Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of Odisha
Introduction: ST Elevation Myocardial Infarction (STEMI) is one of the most fatal emergencies contributing to significant morbidity and mortality due to coronary artery disease. Fibrinolytic agents are most effective agents used for the management of STEMI. However, there is a relative paucity of da...
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JCDR Research and Publications Private Limited
2022-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/17184/55784_CE(AD)_F[SH]_PF1(SC_OM)_PFA(SHU)_PB(SC_SHU)_PN(SHU).pdf |
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| author | Lorika Sahu Nirmal Kumar Mohanty Siddhartha Goutam Trupti Rekha Swain |
| author_facet | Lorika Sahu Nirmal Kumar Mohanty Siddhartha Goutam Trupti Rekha Swain |
| author_sort | Lorika Sahu |
| collection | DOAJ |
| description | Introduction: ST Elevation Myocardial Infarction (STEMI) is one of the most fatal emergencies contributing to significant morbidity and mortality due to coronary artery disease. Fibrinolytic agents are most effective agents used for the management of STEMI. However, there is a relative paucity of data comparing the effectiveness of thrombolytic agents that can provide insight for proper selection of this class of drugs.
Aim: To compare the efficacy of streptokinase, tenecteplase, and reteplase in patients of STEMI in terms of post-thrombolytic resolution by observing reduction of ST-segment elevation at 90 minutes of thrombolytic and assessing for mortality within 30 days of therapy.
Materials and Methods: This prospective, single-centre, observational, hospital-based study was conducted in the Department of Cardiology in collaboration with the Department of Pharmacology at Srirama Chandra Bhanja Medical College and Hospital, Odisha, India, from February 2020 to January 2022. The study involved 300 patients (100 patients in each group) being treated with streptokinase, or tenecteplase,or reteplase. A reduction of ≥50% of the initial ST elevation was considered as successful thrombolysis. The efficacy of the thrombolysis with these agents was assessed based on the extent of ST resolution in Electrocardiogram (ECG) at 90 minutes and observing 30 day mortality thereafter. Categorical data were evaluated using Chi-square test and the means were evaluated using Analysis of Variance (ANOVA).
Results: There was no statistically significant difference between the three groups with respect to ST segment reduction. At 90 minutes of thrombolysis, 75%, 76%, 72% patients showed reduction in the ST segment in the Streptokinase, Tenecteplase and Reteplase group, respectively (p-value=0.79). A total of nine, five and eight deaths were seen in the streptokinase, tenecteplase and reteplase group, respectively within a span 30 days (p-value=0.52).
Conclusion: Streptokinase, tenecteplase and reteplase were equally efficacious for thrombolysis in terms of thrombus resolution and preventing mortality, when started early. |
| first_indexed | 2024-04-10T21:08:59Z |
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| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T21:08:59Z |
| publishDate | 2022-12-01 |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-9bfbfe369ac5426bbf08345dc200b6bb2023-01-21T06:05:05ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-12-011612FC01FC0510.7860/JCDR/2022/55784.17184Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of OdishaLorika Sahu0Nirmal Kumar Mohanty1Siddhartha Goutam2Trupti Rekha Swain3Junior Resident, Department of Pharmacology, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India.Associate Professor, Department of Cardiology, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India.Senior Resident, Department of Pharmacology, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India.Professor and Head, Department of Pharmacology, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India.Introduction: ST Elevation Myocardial Infarction (STEMI) is one of the most fatal emergencies contributing to significant morbidity and mortality due to coronary artery disease. Fibrinolytic agents are most effective agents used for the management of STEMI. However, there is a relative paucity of data comparing the effectiveness of thrombolytic agents that can provide insight for proper selection of this class of drugs. Aim: To compare the efficacy of streptokinase, tenecteplase, and reteplase in patients of STEMI in terms of post-thrombolytic resolution by observing reduction of ST-segment elevation at 90 minutes of thrombolytic and assessing for mortality within 30 days of therapy. Materials and Methods: This prospective, single-centre, observational, hospital-based study was conducted in the Department of Cardiology in collaboration with the Department of Pharmacology at Srirama Chandra Bhanja Medical College and Hospital, Odisha, India, from February 2020 to January 2022. The study involved 300 patients (100 patients in each group) being treated with streptokinase, or tenecteplase,or reteplase. A reduction of ≥50% of the initial ST elevation was considered as successful thrombolysis. The efficacy of the thrombolysis with these agents was assessed based on the extent of ST resolution in Electrocardiogram (ECG) at 90 minutes and observing 30 day mortality thereafter. Categorical data were evaluated using Chi-square test and the means were evaluated using Analysis of Variance (ANOVA). Results: There was no statistically significant difference between the three groups with respect to ST segment reduction. At 90 minutes of thrombolysis, 75%, 76%, 72% patients showed reduction in the ST segment in the Streptokinase, Tenecteplase and Reteplase group, respectively (p-value=0.79). A total of nine, five and eight deaths were seen in the streptokinase, tenecteplase and reteplase group, respectively within a span 30 days (p-value=0.52). Conclusion: Streptokinase, tenecteplase and reteplase were equally efficacious for thrombolysis in terms of thrombus resolution and preventing mortality, when started early.https://www.jcdr.net/articles/PDF/17184/55784_CE(AD)_F[SH]_PF1(SC_OM)_PFA(SHU)_PB(SC_SHU)_PN(SHU).pdfacute coronary syndromecardiologyfibrinolytic agentsmortalitythrombolysis |
| spellingShingle | Lorika Sahu Nirmal Kumar Mohanty Siddhartha Goutam Trupti Rekha Swain Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of Odisha Journal of Clinical and Diagnostic Research acute coronary syndrome cardiology fibrinolytic agents mortality thrombolysis |
| title | Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of Odisha |
| title_full | Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of Odisha |
| title_fullStr | Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of Odisha |
| title_full_unstemmed | Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of Odisha |
| title_short | Comparative Efficacy between Streptokinase, Tenecteplase and Reteplase in ST Elevated Myocardial Infarction among Patients Attending Tertiary Care Hospital of Odisha |
| title_sort | comparative efficacy between streptokinase tenecteplase and reteplase in st elevated myocardial infarction among patients attending tertiary care hospital of odisha |
| topic | acute coronary syndrome cardiology fibrinolytic agents mortality thrombolysis |
| url | https://www.jcdr.net/articles/PDF/17184/55784_CE(AD)_F[SH]_PF1(SC_OM)_PFA(SHU)_PB(SC_SHU)_PN(SHU).pdf |
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