• Pak J Med Sci · Jul 2015

    Psychosocial risk factors of myocardial infarction and adverse effects of streptokinase in public sector hospitals.

    • Saira Afzal, Muhammad Arif Khan, Hafiz Muhammad, Ayesha Ashraf, and Maria Afzal.
    • Saira Afzal, MBBS, MCPS, M.PHIL, FCPS Chairperson and Head, Department of Community Medicine, King Edward Medical University, Lahore, Pakistan.
    • Pak J Med Sci. 2015 Jul 1; 31 (4): 821826821-6.

    ObjectivesThis study investigated the psychosocial risk factors of myocardial infarction and time related adverse effects of administration of streptokinase on short-term morbidity and mortality in patients with ST-segment-elevation myocardial infarction (STEMI).MethodsOne hundred patients with STEMI treated with streptokinase in the hospital setting were prospectively enrolled in the study. The primary outcome parameter was the incidence of major adverse cardiac events. During hospital stay the psychosocial and demographic risk factors were also investigated.ResultsThe overall mortality rate was similar in both groups and it was not significant. (5.7% vs 14.5%; P = 0.18). The number of recurrent chest pain was significantly higher in the group 2 compared to the group 1 (25% vs 62.5%; P = .01). The number of hypotesion was significantly higher in the group 1 as compared to the group 2 (30.7% vs 6.2%; P = .009). The demographic and psychosocial risk factors were recorded.ConclusionsThe early intravenous administration of streptokinase in the hospital setting leads to a reduced rate of major cardiovascular events compared to delayed administration beyond 2 hours. However, mortality rates were not significantly affected. Secondary prevention should be targeted on modifiable demographic, dietary, and psychosocial risk factors of STEMI.

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