A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not

Nura Ibrahim Maiyadi; Mostafa Attia Al Sawasany; Hatem Abdelateif Kholeif

doi:doi:10.11648/j.ccr.20210504.14

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A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not

Nura Ibrahim Maiyadi, Mostafa Attia Al Sawasany, Hatem Abdelateif Kholeif

Published in Cardiology and Cardiovascular Research (Volume 5, Issue 4)

Received: 24 October 2021 Accepted: 9 November 2021 Published: 17 November 2021

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Abstract

Coronary blood flow in an infarct related artery (IRA) in patients that had streptokinase (SK), as the fibrinolytic of choice before percutaneous intervention (PCI), in comparison to the blood flow in patients that underwent primary percutaneous intervention (PPCI) has not been well understood or considered for studies in recent times. All patients presenting with STEMI diagnosis within less than 12 hours from diagnosis either at the centre or referred to the center after SK were screened. 200 patients were randomized into primary PCI (PPCI) or pharmacoinvasive PCI following SK (PhI-SK) administration 3-24 hours after SK. Failed SK patients underwent rescue PCI immediately. The outcome of IRA patency pre- and post PCI in both groups along with short term outcome of bleeding, re-infarction or cardiovascular death in 30 days were looked at. The end points were reached in 81 of 89 (91.0%) in the SK group and 21 of 98 (21.4%) in the PPCI group (p-value <0.001), while TIMI 3 flow was seen in 87 of 89 (98.7%) patients post PCI in the SK group and 69 of 98 (70.4%) patients of PPCI (p-value <0.001). The outcomes of bleeding, MI and death were not different among the groups. We concluded that Fibrinolysis with SK is a viable and safe reperfusion strategy in STEMI especially in low- and middle-income countries (LMICs), where PPCI is not commonly available within the guideline recommended time. It can reduce stress and risk of complications that can occur during PPCI. There is no any difference in the early outcomes of bleeding, MI and death between the two groups.

Published in	Cardiology and Cardiovascular Research (Volume 5, Issue 4)
DOI	10.11648/j.ccr.20210504.14
Page(s)	176-182
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Primary PCI, Streptokinase, Infarction

References

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[12]	Roule V, Ardouin P, Blanchart K, et al. Prehospital fibrinolysis versus primary percutaneous coronary intervention in ST-elevation myocardial infarction: A systematic review and meta-analysis of randomized controlled trials. Crit Care. 2016; 20 (1): 1-7. doi: 10.1186/s13054-016-1530-z
[13]	Khraishah H, Alahmad B, Secemsky E, et al. Comparative Effectiveness of Reperfusion Strategies in Patients with ST-Segment Elevation Myocardial Infarction: A Secondary Analysis of the Acute Coronary Syndrome Quality Improvement in Kerala (ACS QUIK) Trial. Glob Heart. 2020; 15 (1): 68. doi: 10.5334/gh.868
[14]	Vora AN, Holmes DN, Rokos I, et al. Fibrinolysis use among patients requiring interhospital transfer for st-segment elevation myocardial infarction care a report from the us national cardiovascular data registry. JAMA Intern Med. 2015; 175 (2): 207-215. doi: 10.1001/jamainternmed.2014.6573
[15]	Sinnaeve PR, Armstrong PW, Gershlick AH, et al. ST-segment-elevation myocardial infarction patients randomized to a pharmaco-invasive strategy or primary percutaneous coronary intervention strategic reperfusion early after myocardial infarction (STREAM) 1-year mortality follow-up. Circulation. 2014; 130 (14): 1139-1145. doi: 10.1161/CIRCULATIONAHA.114.009570
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APA Style

Nura Ibrahim Maiyadi, Mostafa Attia Al Sawasany, Hatem Abdelateif Kholeif. (2021). A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not. Cardiology and Cardiovascular Research, 5(4), 176-182. https://doi.org/10.11648/j.ccr.20210504.14

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ACS Style

Nura Ibrahim Maiyadi; Mostafa Attia Al Sawasany; Hatem Abdelateif Kholeif. A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not. Cardiol. Cardiovasc. Res. 2021, 5(4), 176-182. doi: 10.11648/j.ccr.20210504.14

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AMA Style

Nura Ibrahim Maiyadi, Mostafa Attia Al Sawasany, Hatem Abdelateif Kholeif. A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not. Cardiol Cardiovasc Res. 2021;5(4):176-182. doi: 10.11648/j.ccr.20210504.14

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@article{10.11648/j.ccr.20210504.14,
  author = {Nura Ibrahim Maiyadi and Mostafa Attia Al Sawasany and Hatem Abdelateif Kholeif},
  title = {A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not},
  journal = {Cardiology and Cardiovascular Research},
  volume = {5},
  number = {4},
  pages = {176-182},
  doi = {10.11648/j.ccr.20210504.14},
  url = {https://doi.org/10.11648/j.ccr.20210504.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20210504.14},
  abstract = {Coronary blood flow in an infarct related artery (IRA) in patients that had streptokinase (SK), as the fibrinolytic of choice before percutaneous intervention (PCI), in comparison to the blood flow in patients that underwent primary percutaneous intervention (PPCI) has not been well understood or considered for studies in recent times. All patients presenting with STEMI diagnosis within less than 12 hours from diagnosis either at the centre or referred to the center after SK were screened. 200 patients were randomized into primary PCI (PPCI) or pharmacoinvasive PCI following SK (PhI-SK) administration 3-24 hours after SK. Failed SK patients underwent rescue PCI immediately. The outcome of IRA patency pre- and post PCI in both groups along with short term outcome of bleeding, re-infarction or cardiovascular death in 30 days were looked at. The end points were reached in 81 of 89 (91.0%) in the SK group and 21 of 98 (21.4%) in the PPCI group (p-value <0.001), while TIMI 3 flow was seen in 87 of 89 (98.7%) patients post PCI in the SK group and 69 of 98 (70.4%) patients of PPCI (p-value <0.001). The outcomes of bleeding, MI and death were not different among the groups. We concluded that Fibrinolysis with SK is a viable and safe reperfusion strategy in STEMI especially in low- and middle-income countries (LMICs), where PPCI is not commonly available within the guideline recommended time. It can reduce stress and risk of complications that can occur during PPCI. There is no any difference in the early outcomes of bleeding, MI and death between the two groups.},
 year = {2021}
}

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TY  - JOUR
T1  - A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not
AU  - Nura Ibrahim Maiyadi
AU  - Mostafa Attia Al Sawasany
AU  - Hatem Abdelateif Kholeif
Y1  - 2021/11/17
PY  - 2021
N1  - https://doi.org/10.11648/j.ccr.20210504.14
DO  - 10.11648/j.ccr.20210504.14
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 176
EP  - 182
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20210504.14
AB  - Coronary blood flow in an infarct related artery (IRA) in patients that had streptokinase (SK), as the fibrinolytic of choice before percutaneous intervention (PCI), in comparison to the blood flow in patients that underwent primary percutaneous intervention (PPCI) has not been well understood or considered for studies in recent times. All patients presenting with STEMI diagnosis within less than 12 hours from diagnosis either at the centre or referred to the center after SK were screened. 200 patients were randomized into primary PCI (PPCI) or pharmacoinvasive PCI following SK (PhI-SK) administration 3-24 hours after SK. Failed SK patients underwent rescue PCI immediately. The outcome of IRA patency pre- and post PCI in both groups along with short term outcome of bleeding, re-infarction or cardiovascular death in 30 days were looked at. The end points were reached in 81 of 89 (91.0%) in the SK group and 21 of 98 (21.4%) in the PPCI group (p-value <0.001), while TIMI 3 flow was seen in 87 of 89 (98.7%) patients post PCI in the SK group and 69 of 98 (70.4%) patients of PPCI (p-value <0.001). The outcomes of bleeding, MI and death were not different among the groups. We concluded that Fibrinolysis with SK is a viable and safe reperfusion strategy in STEMI especially in low- and middle-income countries (LMICs), where PPCI is not commonly available within the guideline recommended time. It can reduce stress and risk of complications that can occur during PPCI. There is no any difference in the early outcomes of bleeding, MI and death between the two groups.
VL  - 5
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Author Information

Nura Ibrahim Maiyadi

Department of Cardiology, Al Azhar University, Cairo, Egypt
Mostafa Attia Al Sawasany

Department of Cardiology, Al Azhar University, Cairo, Egypt
Hatem Abdelateif Kholeif

Department of Cardiology, Al Azhar University, Cairo, Egypt

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APA Style

Nura Ibrahim Maiyadi, Mostafa Attia Al Sawasany, Hatem Abdelateif Kholeif. (2021). A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not. Cardiology and Cardiovascular Research, 5(4), 176-182. https://doi.org/10.11648/j.ccr.20210504.14

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ACS Style

Nura Ibrahim Maiyadi; Mostafa Attia Al Sawasany; Hatem Abdelateif Kholeif. A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not. Cardiol. Cardiovasc. Res. 2021, 5(4), 176-182. doi: 10.11648/j.ccr.20210504.14

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AMA Style

Nura Ibrahim Maiyadi, Mostafa Attia Al Sawasany, Hatem Abdelateif Kholeif. A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not. Cardiol Cardiovasc Res. 2021;5(4):176-182. doi: 10.11648/j.ccr.20210504.14

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@article{10.11648/j.ccr.20210504.14,
  author = {Nura Ibrahim Maiyadi and Mostafa Attia Al Sawasany and Hatem Abdelateif Kholeif},
  title = {A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not},
  journal = {Cardiology and Cardiovascular Research},
  volume = {5},
  number = {4},
  pages = {176-182},
  doi = {10.11648/j.ccr.20210504.14},
  url = {https://doi.org/10.11648/j.ccr.20210504.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20210504.14},
  abstract = {Coronary blood flow in an infarct related artery (IRA) in patients that had streptokinase (SK), as the fibrinolytic of choice before percutaneous intervention (PCI), in comparison to the blood flow in patients that underwent primary percutaneous intervention (PPCI) has not been well understood or considered for studies in recent times. All patients presenting with STEMI diagnosis within less than 12 hours from diagnosis either at the centre or referred to the center after SK were screened. 200 patients were randomized into primary PCI (PPCI) or pharmacoinvasive PCI following SK (PhI-SK) administration 3-24 hours after SK. Failed SK patients underwent rescue PCI immediately. The outcome of IRA patency pre- and post PCI in both groups along with short term outcome of bleeding, re-infarction or cardiovascular death in 30 days were looked at. The end points were reached in 81 of 89 (91.0%) in the SK group and 21 of 98 (21.4%) in the PPCI group (p-value <0.001), while TIMI 3 flow was seen in 87 of 89 (98.7%) patients post PCI in the SK group and 69 of 98 (70.4%) patients of PPCI (p-value <0.001). The outcomes of bleeding, MI and death were not different among the groups. We concluded that Fibrinolysis with SK is a viable and safe reperfusion strategy in STEMI especially in low- and middle-income countries (LMICs), where PPCI is not commonly available within the guideline recommended time. It can reduce stress and risk of complications that can occur during PPCI. There is no any difference in the early outcomes of bleeding, MI and death between the two groups.},
 year = {2021}
}

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TY  - JOUR
T1  - A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not
AU  - Nura Ibrahim Maiyadi
AU  - Mostafa Attia Al Sawasany
AU  - Hatem Abdelateif Kholeif
Y1  - 2021/11/17
PY  - 2021
N1  - https://doi.org/10.11648/j.ccr.20210504.14
DO  - 10.11648/j.ccr.20210504.14
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 176
EP  - 182
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20210504.14
AB  - Coronary blood flow in an infarct related artery (IRA) in patients that had streptokinase (SK), as the fibrinolytic of choice before percutaneous intervention (PCI), in comparison to the blood flow in patients that underwent primary percutaneous intervention (PPCI) has not been well understood or considered for studies in recent times. All patients presenting with STEMI diagnosis within less than 12 hours from diagnosis either at the centre or referred to the center after SK were screened. 200 patients were randomized into primary PCI (PPCI) or pharmacoinvasive PCI following SK (PhI-SK) administration 3-24 hours after SK. Failed SK patients underwent rescue PCI immediately. The outcome of IRA patency pre- and post PCI in both groups along with short term outcome of bleeding, re-infarction or cardiovascular death in 30 days were looked at. The end points were reached in 81 of 89 (91.0%) in the SK group and 21 of 98 (21.4%) in the PPCI group (p-value <0.001), while TIMI 3 flow was seen in 87 of 89 (98.7%) patients post PCI in the SK group and 69 of 98 (70.4%) patients of PPCI (p-value <0.001). The outcomes of bleeding, MI and death were not different among the groups. We concluded that Fibrinolysis with SK is a viable and safe reperfusion strategy in STEMI especially in low- and middle-income countries (LMICs), where PPCI is not commonly available within the guideline recommended time. It can reduce stress and risk of complications that can occur during PPCI. There is no any difference in the early outcomes of bleeding, MI and death between the two groups.
VL  - 5
IS  - 4
ER  -

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