The effect of streptokinase therapy in STEMI and conventional therapy in NSTEMI patients on TIMI risk index, B-type natriuretic peptide and high-sensitive C-reactive protein.

Abstract

OBJECTIVE:

In this study, it was aimed to investigate the effect of streptokinase therapy in ST elevation myocardial infarction (STEMI) and conventional therapy in non-ST elevation myocardial infarction (NSTEMI) patients on the thrombolysis in myocardial infarction (TIMI) risk index (TRI), B-type natriuretic peptide (BNP), and high-sensitive C-reactive protein (hs-CRP) levels.

METHODS:

Eighty-six STEMI (male/female ratio: 65/21, mean age 57.52±9.87 years) and eighty NSTEMI patients (male/female ratio: 50/30, mean age 57.6±1.7 years) were included in this prospective observational study. Hs-CRP and BNP were measured and TIMI risk index was calculated in all patients. Coronary angiography was performed in all patients for principally determining TIMI flow rate. Chi-square test, paired t-test or Wilcoxon signed rank test, ANOVA and Spearman correlation analysis were used for statistical analysis where appropriate.

RESULTS:

STEMI patients had higher systolic blood pressure, heart rate, BNP and hs-CRP values than NSTEMI patients at admission (p=0.04, p=0.01, p=0.001 and p=0.01, respectively). Thrombolytic therapy in STEMI patients resulted in statistically significant higher levels of BNP, hs-CRP and TRI values compared to baseline levels (p=0.001, p=0.001 and p=0.042, respectively). For NSTEMI patients conventional therapy yielded statistically significant decrease in systolic blood pressure levels and increase in TRI (p=0.001 and p=0.047, respectively). We found significantly lower BNP, hs-CRP in patients with higher TIMI flow rate (p=0.001 and p=0.001 respectively).

CONCLUSION:

Thrombolytic therapy with streptokinase failed to decrease BNP, hs-CRP and TRI values in STEMI patients. Conventional therapy in NSTEMI patients also resulted in higher TRI values than baseline values. We reached TIMI 3 flow in only 10.5% of the study patients, which may be responsible for our findings.

• Authors: Ibrahim Halil Kurt, Mustafa Kemal Batur, Ilker Unal
• Journal: Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology (Anadolu Kardiyol Derg) Vol. 11 Issue 6 Pg. 530-5 (Sep 2011) ISSN: 1308-0032 [Electronic] Turkey
• PMID: 21821500 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Fibrinolytic Agents
• Natriuretic Peptide, Brain
• C-Reactive Protein
• Streptokinase

Topics

• C-Reactive Protein (metabolism)
• Coronary Angiography
• Female
• Fibrinolytic Agents (administration & dosage, therapeutic use)
• Humans
• Male
• Middle Aged
• Myocardial Infarction (blood, diagnostic imaging, drug therapy, therapy)
• Myocardial Reperfusion
• Natriuretic Peptide, Brain (blood)
• Prospective Studies
• Streptokinase (administration & dosage, therapeutic use)
• Thrombolytic Therapy
• Treatment Outcome