Post-Thrombolytic St-Segment Resolution Outcome in Acute Myocardial Infarction Patients Treated with Streptokinase: A Prospective Observational Study from Koppal

Background: Acute myocardial infarction remains a leading cause of cardiovascular mortality worldwide, with early reperfusion therapy being critical for myocardial salvage. ST-segment resolution following thrombolytic therapy serves as a practical, non-invasive marker for assessing reperfusion success. This study aimed to evaluate post-thrombolytic ST-segment resolution outcomes in acute myocardial infarction patients treated with streptokinase at a tertiary care center in Koppal. Material and Methods: This prospective observational study was conducted at KIMS Teaching Hospital, Koppal over 12 months. Fifty-six patients diagnosed with ST-elevation myocardial infarction presenting within 12 hours of symptom onset were included. Patients received intravenous streptokinase (1.5 million units). Electrocardiograms were recorded at baseline and 90 minutes post-thrombolysis. ST-segment resolution was categorized as complete (≥70%), partial (30-69%), or absent (<30%). Patients were followed for in-hospital complications including arrhythmias, cardiogenic shock, heart failure, and mortality. Results: Among 56 patients (mean age 54.82±11.43 years, 78.6% male), complete ST-segment resolution was achieved in 32 patients (57.1%), partial resolution in 16 patients (28.6%), and no resolution in 8 patients (14.3%). Complications occurred in 1 patient (3.1%) with complete resolution compared to 7 patients (87.5%) without resolution (p<0.001). Cardiogenic shock was the most common complication in the non-resolution group (50%), while mortality was significantly higher in patients without ST-segment resolution (25% vs 0%, p=0.003). Conclusion: ST-segment resolution at 90 minutes post-thrombolysis is a reliable, cost-effective predictor of successful reperfusion and favorable clinical outcomes in STEMI patients. Patients without adequate ST-segment resolution should be considered for early invasive intervention.

Keywords: Acute Myocardial Infarction; ST-segment Resolution; Streptokinase; Thrombolysis; Reperfusion.