Resolution of ST-Segment, Pain Level, and Arrythmia as A Tool For Assessing The Efficacy of Reperfusion Therapy in STEMI Patient Hospital Kanjuruhan

Author : A. N. Lukito, G. A. Pawintri , A. B. Santoso
Upload Date : 19-04-2018

Background : Acute coronary syndrome is a major cardiovascular problem that causes increase mortality and morbidity, including ST segment elevation myocardial infarction (STEMI). Treatment for STEMI patients in Kanjuruhan Hospital using pharmacotheraphy reperfusion (Streptokinase) as Primary PCI action takes more than 2 hours for prepare until transfer to PCI center. The aim of study is to prove the rate of success of streptokinase reperfusion therapy by looking for signs of thrombolytic efficacy.

Methods : Cohort study had been done to compare the effect of pre and post streptokinase therapy with resolution of ST segments, pain relief, and reperfusion arrhythmia. Paired sample t-test and chi-square test was used to analyze the data sample. The study was set in emergency department setting from April-July 2017.

Results : 16 patients had met the criteria. Paired sample t-test showed p=0.011 means that a significant difference of pain scale before and after thrombolytic. Pain relief is associated with ST segment resolution (p=0.05). 50% of the patients showed complete resolution (> 70% ST-resolution), 30% of the patients showed partial resolution (30-70% ST-resolution), and 20% of the patients with no resolution (<30% ST-resolution). 20% of the patients with no resolution also showed no decrease of pain scale > 50% (p=0.05). 37.5% of patients showed arrhythmias, 4 arrhythmias occur in partial resolution group and 1 artimia occurs in the no resolution group. There are 3 PVC patients, 1 with PVC manifesting VT, 1 with VT, 1 with AV-block (p=0.108). Therefore the arrhythmias did not correlate with ST-resolution, and if only arrhythmias (except PVC) not always showed the successes of reperfusion.

Conclusion : Streptokinase reperfusion does affects the successes of STEMI patients treatment. Analysis of pain score, ST segment resolution, and arrythmia are useful to decide the sucessful of reperfusion.

KEYWORDS : Reperfusion, Streptokinase, ACS, STEMI

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