Comparison of In Hospital Outcomes in ST Elevation Myocardial Infarction Patients with and Without Streptokinase Therapy

Background: ST-Elevation Myocardial Infarction (STEMI) is a life-threatening condition that demands immediate medical attention. Streptokinase (STK) is a cost-effective thrombolytic agent frequently used to restore blood flow to the heart muscle, especially in settings with limited resources. Although tenecteplase therapy has shown superior efficacy, STK remains the preferred thrombolytic treatment in our country due to the economic challenges faced by many families. Objective: To evaluate and compare in-hospital mortality, complications, and recovery outcomes between STEMI patients receiving Streptokinase and non-thrombolytic therapy. Method and Materials: This prospective observational study was conducted from January to June 2024 in the Coronary Care Unit of North East Medical College and Hospital, Sylhet. A total of 101 STEMI patients were included, grouped into STK (n=63) and Non-STK (n=38) categories. Data on demographics, clinical history, ECG findings, and outcomes were collected and analyzed statistically. Ethical approval and informed consent were obtained prior to the study. Results: In the STK group, 93.7% were male, with a mean age of 49.84 years, compared to 73.7% male and a mean age of 57.05 years in the Non-STK group. Mortality was 15.9% in the STK group and 23.7% in the Non-STK group. Mechanical complications like ALVF occurred in 38 STK patients and 26 Non-STK patients. Electrical complications included 4 cases of third-degree AV block in the STK group versus 2 in the Non-STK group. Conclusion: This study highlights the critical impact of streptokinase (STK) administration on in- hospital outcomes in patients with ST-segment elevated myocardial infarction (STEMI).