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Comparison of TIMI Flow Between Streptokinase and Alteplase in Patients with ST Elevation Myocardial Infarction After Successful Fibrinolytic at Haji Adam Malik General Hospital Medan

Author : D. Ashrinda, R. Hasan, C. A. Andra, Z. Mukhtar, H. Hasan
Upload Date : 19-04-2018

Background: ST Elevation Myocardial Infarction (STEMI) is the process of rupture of atherosclerotic plaque by thrombus formation resulting in total occlusion of the coronary artery. Patients with STEMI with onset ≤ 12 hours, it is necessary to take Primary Percutaneous Coronary Intervention (pPCI) action immediately, but if the pPCI could not be performed due to non-fulfillment facilities, another optional therapy is fibrinolytics in order to improve blood flow in the coronary due to occlusion caused by thrombus, thus reducing infarction expansion, improving myocardial function, improving life expectancy. Fibrinolytic agents are commonly used, Streptokinase and Alteplase, which have distinct advantages and disadvantages.

Methods: This was a retrospective study in STEMI patients onset ≤ 12 hours, had performed successfully fibrinolytic with Streptokinase and Alteplase treated at Haji Adam Malik General Hospital from January 2015 to August 2017. This study was divided into two groups, one group with Streptokinase, and other groups with Alteplase. TIMI flow was assessed by coronary angiography recording which previously had Enoxaparin for 5 days.

Results: A total of 54 patients who had successfully performed fibrinolytic therapy, each Streptokinase and Alteplase group counts were 27 patients. Which the mean age was 54 ± 8 years, 48 patients (88.9%) were male. The age and smoking are highest risk factors. Anterior STEMI counted 31 samples (57.4%), with mean 4-hour onset of pain. In the Streptokinase group, there were 9 patients (33.3%) with TIMI flow 2, and 18 patients (66.7%) with TIMI flow 3. While in the Alteplase group, there were 11 patients (40.7%) with TIMI flow 2, 16 patients (59.3%) with TIMI flow 3, with p value = 0.573.

Conclusion: There is no difference of TIMI flow between Streptokinase and Alteplase STEMI patients after successful fibrinolytic theraphy.

KEYWORDS : STEMI, Fibrinolytic, Streptokinase, Alteplase, TIMI Flow


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