title: [Evaluation of fibrinolysis with streptokinase in ST-elevation myocardial infarction admitted to emergency department].
abstract: BACKGROUND
  Fibrinolysis during ST elevation myocardial infarction (STEMI) is feasible in the emergency departments (ED), and this reduces the delay from first medical contact to coronary reperfusion. The aim of the study is to: 1) Evaluate fibrinolysis with streptokinase (SK) in STEMI admitted to the ED. 2) identify clinical criteria predictive of fibrinolysis success.
  
  
  METHODS
  prospective study (July 2008-March 2012). Inclusion of STEMI thrombolysed by SK. Fibrinolysis success was defined according to clinical and Electrocardiogram criteria. Multivariate study is used to identify the factors associated with thrombolysis success.
  
  
  RESULTS
  Out of the 329 STEMI enrolled during the study period, 224 (68%) were thrombolysed. Mean age = 57 ± 11 years (20-86 years) sex ratio = 6. The average time chest pain - emergency admission was 195 ± 177 min (15 min to 12 hours). The 2/3 of patients had consulted during the first 3 hours. The average success rate of thrombolysis was 59% and reached 83% the first hour, 66% the second hour and 58.7% the third hour. In multivariate analysis, the three independent predictors factors of a fibrinolysis success were: active smoking, current treatment with beta blockers and the delay from onset chest pain to the ED visit less than 180 min. Conversely, diabetes was associated with fibrinolysis failure. Fibrinolysis got complicated by two intracerebral hemorrhages. Three patients had died in the ED.
  
  
  CONCLUSIONS
  Two thirds of patients with STEMI have consulted 3 h after onset of chest pain. Fibrinolysis with streptokinase was effective in 59% of cases.
authors.forename: Bechir
authors.initials: B
authors.lastname: Bouhajja
authors.forename: Sami
authors.initials: S
authors.lastname: Souissi
authors.forename: Hanene
authors.initials: H
authors.lastname: Ghazali
authors.forename: Anouar
authors.initials: A
authors.lastname: Yahmadi
authors.forename: Moez
authors.initials: M
authors.lastname: Mougaida
authors.forename: Noura
authors.initials: N
authors.lastname: Laamouri
authors.forename: Ali
authors.initials: A
authors.lastname: Sellami
authors.forename: Mahbouba
authors.initials: M
authors.lastname: Chkir
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D063285:Fibrin Clot Lysis Time / Q000379:methods*; D005342:Fibrinolysis; D005343:Fibrinolytic Agents; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D010343:Patient Admission; D011379:Prognosis; D013300:Streptokinase; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase