title: Door to needle time of streptokinase and ST segment resolution assessing the efficacy of reperfusion therapy at Karachi Institute of Heart Diseases.
abstract: BACKGROUND
  Early start of treatment including coronary revascularisation has been recognised as crucial variable in the outcome of acute ST-segment Elevation Myocardial Infarction (STEMI). Objectives of the study were to determine the magnitude of ST-segment resolution after thrombolytic therapy predicts short- and long-term outcomes in patients with an Acute Myocardial Infarction (AMI).
  
  
  METHODS
  The duration of quasi experimental study was 3 years, from July 2006 to June 2009, conducted at Karachi Institute of Heart Diseases. Total 1,023 patients of STEMI treated with streptokinase (SK) were enrolled in the study.
  
  
  RESULTS
  Of the total 1023, 689 (67.3%) patients were males and 334 (32.6%) were females. Six hundred and twenty-nine (61.5%) were successfully resolved after thrombolytic therapy while in 395 (38.5%) patients ST-segment could not resolve into 3 conventional ST-segment resolution categories at 60 minute and 90 minute after thrombolysis. Three hundred and twelve (30%) and 444 (43.4%) with complete resolution, 344 (33.62%) and 325 (31.76%) with partial resolution, 367 (35.8%) and 491 (19.29%) were with no resolution at 60 and 90 minutes respectively.
  
  
  CONCLUSIONS
  Shock, congestive heart failure, and recurrent angina and ischemia occurred more often in patients with partial or no ST resolution as compare to complete resolution.
authors.affiliation: Karachi Institute of Heart Diseases, Karachi, Pakistan. dr.riffatsultana2@gmail.com
authors.forename: Riffat
authors.initials: R
authors.lastname: Sultana
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Sultana
authors.forename: Abdul
authors.initials: A
authors.lastname: Rasheed
authors.forename: Zahid
authors.initials: Z
authors.lastname: Rasheed
authors.forename: Mansoor
authors.initials: M
authors.lastname: Ahmed
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ishaq
authors.forename: Abdus
authors.initials: A
authors.lastname: Samad
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D015425:Myocardial Reperfusion; D011379:Prognosis; D012307:Risk Factors; D013300:Streptokinase / Q000008:administration & dosage*; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase