VALIDATION OF ECG CRITERIA OF SUCCESSFUL THROMBOLYSIS

Abstract

Objective: To determine the frequency of TIMI (Thrombolysis in MyocardialInfarction) grade 3 on angiography in patients presenting with acute STEMI whofulfill ECG criteria of successful thrombolysis after being thrombolysed withstreptokinase.

Methodology: This descriptive study was conducted at Chaudhry Pervaiz ElahiInstitute of Cardiology, Multan from August 2013 to March 2014. Patients withacute STEMI who were thrombolysed with streptokinase and whom ECGs weremeeting criteria of successful thrombolysis (showing ST segment resolution of50% from J point) were included. These patients under went coronaryangiography to evaluate the frequency of TIMI grade 3 flow. Data was analysedusing SPSS version 16.

Results: A total of 178 patients were studied. Males were 84.8% (n=151). Meanage was 47.06±1.26 years(25-65 years). TIMI grade 3 flow on angiography wasachieved in 82.6%(n=147) while 17.4% (n=31) patients did not. There was nostatistically difference of TIMI grade 3 between males and females (81.5% vs.88.9%, p=0.348). In comparison to non-diabetics, less number of diabeticpatients achieved TIMI grade 3 flow (88.5% vs. 66.7%,p=0.001). Similarly, nonhypertensivehave got more TIMI grade 3 vs. hypertensive patients(92.2% vs.65.1%,p=0.000). There was no statistical difference between the patients withfamily history of IHD and those without family history of IHD (74.4% vs.85.2%,p= 0.105). Surprisingly, smokers had got more TIMI grade 3 ascompared to non-smokers (88.1% vs. 75.3%, p = 0.026).

Conclusion: We concluded that ECG criteria of successful thrombolysis is verygood predictor of infarct related artery patency.