Efficacy and safety concerns with thrombolysis in acute myocardial infarction in Insein General Hospital (ESCORT-IGH).

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dc.contributor.authorNe Myo Aung
dc.contributor.authorMar Mar Kyi
dc.contributor.authorTint Tint Kyi
dc.contributor.authorHnin Yee Lwin
dc.contributor.authorAye Mya Sandar
dc.contributor.authorSoe Thiha
dc.contributor.authorMyo Thant
dc.date.accessioned2015-10-22T08:11:28Z
dc.date.available2015-10-22T08:11:28Z
dc.date.issued2015-03-01
dc.description.abstractBackground - Although patients with ST elevation myocardial infarction should be ideally treated with primary coronary intervention (PCI), due to limited availability of PCI capable hospitals, thrombolysis remains the mainstay treatment in Myanmar. It is imperative that evidence is necessary to prove the efficacy and safety of thrombolysis in district hospital setting in Myanmar. Methods - Patients with acute myocardial infarction were studied during a period of 21 months in the medical ward of Insein General Hospital (IGH), a (300 bedded) hospital which has no facilities for PCI. Streptokinase was used for thrombolysis. Study was set up to achieve “call to needle time of 25 minutes”. Primary endpoint was ST resolution at 90 minutes post-thrombolysis and secondary endpoint was 7 days survival post-thrombolysis. Adverse reactions including haemorrhage were recorded. Results - One hundred and eighteen patients (78%) out of one hundred and fifty one study cases were eligible for thrombolysis. Among the thrombolysis patients, male to female ratio was 1.63 and mean age was 60 years (22 - 86 yr). Median time of thrombolysis since onset of pain was 4.7 hours. Primary end point of ST resolution at 90 min was achieved in 58% (69/118) in thrombolysis group and 0% (0/33) in non-thrombolysis group. Secondary end point of 7 day survival was achieved in 89% (105/118) in thrombolysis group and 6% (2/33) in non-thrombolysis group. Thrombolysis favours ST resolution (p < 0.0001) and 7 day survival (p < 0.0001) better than non-thrombolysis. Statistically non-significant minor bleeding (gum bleeding and epistaxis) was observed in 3% (4/118) (p = 0.52) in the treatment group but there was no fatal bleeding and anaphylaxis. Conclusion - Thrombolysis using streptokinase is safe and highly effective in acute ST-elevation myocardial infarction in district hospital setting.en_US
dc.format.extent45p.en_US
dc.identifier.citationNe Myo Aung, Mar Mar Kyi, Tint Tint Kyi, Hnin Yee Lwin, Aye Mya Sandar, Soe Thiha, Myo Thant. Myanmar Medical Journal. 2015; 57 (1 ): 24 - 29.en_US
dc.identifier.issn0007-6295
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/164716
dc.language.isoenen_US
dc.publisherMyanmar Medical Associationen_US
dc.rightsMyanmar Medical Associationen_US
dc.subjectSTEMIen_US
dc.subjectPCIen_US
dc.subjectStreptokinaseen_US
dc.subject.meshMyocardial Infarctionen_US
dc.subject.meshThrombolytic Therapyen_US
dc.titleEfficacy and safety concerns with thrombolysis in acute myocardial infarction in Insein General Hospital (ESCORT-IGH).en_US
dc.typeArticleen_US
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