Impact of Thrombolytic Therapy on Electrolyte Imbalance in Acute Myocardial Infarction

Abstract Background: Electrolyte imbalance after acute myocardial infarction (AMI) is a common occurrence and is managed by thrombolytic treatment for clinical improvement. Therefore, the current study aimed to evaluate the changes in the electrolyte levels in the pre- and postthrombolytic phase of AMI. Methodology: Blood samples were collected from 119 newly diagnosed AMI (both ST-segment elevation myocardial infarction [STEMI] and non-STEMI) patients before initializing thrombolysis using streptokinase, tenecteplase and reteplase and 8 h after thrombolysis. Biochemical parameters such as lipid profile, creatine kinase myocardial band, urea, and creatinine along with the electrolytes such as sodium, potassium, calcium, magnesium, and chloride were estimated. The significant difference between pre- and post-thrombolysis was evaluated, with P < 0.05 being considered statistically significant. Results: Among the patients, 70 were diagnosed with ST-elevation MI (STEMI) and 49 with non-STEMI. The decrease in the mean levels of serum calcium ( P = 0.03) and increase in the mean levels of magnesium ( P < 0.0001), sodium ( P = 0.0173), and chloride ( P = 0.0001) was statistically significant with but not with regard to potassium ( P = 0.19). Imbalanced levels of magnesium, sodium, and potassium were seen in 36, 56, and 14 patients, respectively, at the prethrombolytic phase and restored in 26, 40, and 12 patients, respectively, after thrombolytic treatment, i.e., at the postthrombolytic phase. Conclusion: Thrombolytic treatment caused a significant decrease in the mean levels of serum calcium and an increase in magnesium, sodium, and chloride, thereby restoring electrolyte balance in AMI patients.