Key result
Diabetes mellitus was associated with a significantly lower rate of complete ST-segment resolution (19.7% vs 48.4%, p<0.001) 90 minutes after streptokinase therapy compared to non-diabetic patients.
Why the study?
Does diabetes mellitus affect the thrombolytic outcome (ST-segment resolution) of streptokinase in patients with acute STEMI?
Cohort (n=187)
No
Does diabetes mellitus affect the thrombolytic outcome (ST-segment resolution) of streptokinase in patients with acute STEMI?
Absolute Event Rate: 19.7% vs 48.4%
p-value: p=<0.001
Diabetes mellitus is associated with poorer thrombolytic outcomes, specifically lower rates of successful ST-segment resolution, following streptokinase administration in patients with acute STEMI.
Diabetes may reduce streptokinase success in STEMI; hypothesis-generating and requires randomized confirmation before practice change.
A prospective interventional study was carried out to compare the thrombolytic effect of streptokinase between diabetic and non-diabetic myocardial infarction patients. Out of 187 study subjects with acute ST segment elevation myocardial infarction (STEMI), admitted at coronary care unit, 126 patients were non-diabetic and 61 patients were diabetic. Streptokinase was administered to all patients. Resolution (reduction) of elevated ST segment was evaluated after 90 min of streptokinase administration. Successful reperfusion (=70% ST-resolution) was significantly higher in non-diabetic than diabetic (p<0.001), while failed reperfusion (<30% ST resolution) was significantly higher in diabetic patients (p<0.001). It may be concluded that diabetes mellitus might affect the thrombolytic outcome of acute myocardial infarction patients with diabetes mellitus. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14108 Medicine TODAY Vol.24(1) 2012 pp.16-19
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Uddin et al. (2013) conducted a cohort in Acute ST segment elevation myocardial infarction (STEMI) (n=187). Diabetes Mellitus vs. Non-diabetic patients was evaluated on Complete ST-resolution (≥70% reduction of ST elevation) at 90 minutes after streptokinase administration (p=<0.001). Diabetes mellitus was associated with a significantly lower rate of complete ST-segment resolution (19.7% vs 48.4%, p<0.001) 90 minutes after streptokinase therapy compared to non-diabetic patients.
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