Streptokinase Thrombolysis Outcomes in Patients with ST-Elevation Myocardial Infarction: A Comparative Cross-Sectional Study of Type 2 Diabetic and Non-Diabetic Patients

Background: ST-elevation myocardial infarction (STEMI) requires timely reperfusion to reduce myocardial damage. In resource-limited healthcare settings, streptokinase remains one of the most commonly used thrombolytic agents. Diabetes mellitus may impair the effectiveness of streptokinase thrombolysis. However, local evidence comparing thrombolytic outcomes between diabetic and non-diabetic STEMI patients remains limited. Objective: To compare the thrombolysis outcomes of streptokinase between type 2 diabetic and non-diabetic patients presenting with ST-elevation myocardial infarction. Methodology: This cross-sectional study was conducted from January to April 2026 at Mardan Medical Complex. A total of 170 STEMI patients eligible for streptokinase thrombolysis were enrolled using consecutive sampling. Patients with contraindications to thrombolysis, cardiogenic shock, severe comorbidities, or incomplete records were excluded. Data were collected using a predesigned questionnaire. Outcomes were assessed by ST-segment resolution on ECG at 90 minutes and clinical improvement in chest pain and dyspnea. Data were analyzed using SPSS version 26, applying Chi-square and independent t-tests, with p<0.05 considered significant. Results: Among 170 STEMI patients (mean age 59.05 ± 12.18 years; 58.8% males), 57.6% were diabetic. Complete ST-segment resolution occurred in 47.1%, while 28.8% and 24.1% showed partial and failed resolution, respectively. Diabetes was significantly associated with lower ST-segment resolution and longer CCU stay (p = 0.006 and p = 0.048). No significant differences were observed for gender (p = 0.94) or history of CAD (p = 0.14), whereas infarct site showed a significant association with ST-segment resolution (p = 0.003). Conclusion: ST-segment resolution after streptokinase was achieved in less than half of STEMI patients. Diabetes mellitus was associated with poorer ST-segment resolution and longer CCU stay. Infarct site significantly influenced reperfusion outcomes, while gender and history of coronary artery disease showed no significant effect.