CLINICAL EVALUATION OF REPERFUSION IN ST ELEVATION MYOCARDIAL INFARCTION WITH NON- INVASIVE MARKERS FOLLOWING THROMBOLYSIS WITH STREPTOKINASE VERSUS TENECTEPLASE.

Abstract

Background: Acute ST elevation myocardial infarction occurs due to an occluded coronary artery and can cause death of the patient. The best modality of treating an occluded coronary artery is a primary PCI. Thrombolytic therapy can however render similar results if administered within 2 hours of symptom onset. The concept of pre-hospital thrombolysis is being advocated in the face of current guidelines. Streptokinase (SK) is the most inexpensive of available thrombolytics but is brin non-specic, antigenic and has to be given as an infusion. Reteplase and Tenecteplase(TNK) are brin specic, non- antigenic and can be given as bolus doses making them good agents for prehospital thrombolysis. Aims: We aimed to study reperfusion after thrombolysis with streptokinase vs tenectepalse based on non-invasive criteria.Methods:98 patients were enrolled in this study at a tertiary care centre in a medical college in Southern India between August 2014 to August 2015. This was a nonrandomised quasi-experimental study. 54 patients received streptokinase and 44 received tenecteplase in the study. Results: The reperfusion rate was 46.4% with streptokinase(SK) and 54.3% with Tenecteplase(TNK). Tenecteplase proved to be a better agent for patients aged more than 74 years and for patients who presented later than 2 hours. The difference between SK and TNK was not found to be signicant. Conclusion: Tenecteplase is not superior to Streptokinase in achieving reperfusion in STEMI.