Title of article :
Effects of streptokinase on reflow in rescue percutaneous coronary intervention
Author/Authors :
Sanatkar، Masoud نويسنده Fellowship Resident, Cardiac Rehabilitation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran , , Shemirani، Hassan نويسنده Professor, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran , , Sanei، Hamid نويسنده Department of Internal Medicine , , Pourmoghaddas، Masoud نويسنده MD, Professor of Interventional Cardiology, Chamran Heart Hospital, Isfahan University of Medical Sciences, Isfahan , , Rabiei، Katayoun نويسنده Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran ,
Issue Information :
دوماهنامه با شماره پیاپی 32 سال 2013
Abstract :
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred treatment
method for ST elevation myocardial infarction (STEMI). However, the required equipments are
not available in all hospitals. Thus, due to shortage of time, some patients receive thrombolysis
therapy first. Patients with chest pain and/or persistent ST segment elevation will then undergo
rescue percutaneous coronary intervention (PCI). The present study evaluated and compared
the frequency of no-reflow phenomenon and 24-hour complications after PCI among patients
who underwent PPCI or rescue PCI.
METHODS: This cross-sectional study assessed no-reflow phenomenon, 24-hour complications,
and thrombolysis in myocardial infarction (TIMI) flow in patients admitted to Chamran
Hospital (Isfahan, Iran) with a diagnosis of STEMI during March-September, 2011. Subjects
underwent PPCI if they had received eptifibatide. Rescue PCI was performed if patients had
chest pain and/or persistent ST segment elevation despite receiving streptokinase (SK).
Demographic characteristics, history of diseases, medicine, angiography findings, PCI type, and
complications during the first 24 hours following PCI were collected. Data was then analyzed by
Student’s t-test, chi-square test, and logistic regression analysis.
RESULTS: A total number of 143 individuals, including 67 PPCI cases (46.9%) and 76 cases of
rescue PCI (53.1%), were evaluated. The mean age of the participants was 58.92 ± 11.16 years
old. Females constituted 18.2% (n = 26) of the whole population. No-reflow phenomenon was
observed in 51 subjects (37.1%). Although 9 patients (6.3%) died during the first 24 hours after
PCI, neither the crude nor the model adjusted for age and gender revealed significant relations
between rescue PCI and death or no-reflow phenomenon. Rescue PCI and no-reflow
phenomenon were not significantly correlated even after adjustments for age, gender, history of
diabetes, hypertension, hyperlipidemia, coronary artery disease, smoking, platelets number,
myocardial infarction level, the extent of stenosis, and the involved artery.
CONCLUSION: According to the present study, although SK is more effective than eptifibatide in
resolution of thrombosis and clots, rescue PCI did not differ from PPCI in terms of the incidence
of no-reflow phenomenon or short-term complications.
Journal title :
Arya Atherosclerosis
Journal title :
Arya Atherosclerosis