PMID- 33614351
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210223
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 1
DP  - 2021 Jan 18
TI  - Factors Associated With Normal Flow (TIMI 3) After Thrombolysis With 
      Streptokinase in ST-Elevation Myocardial Infarction: A Prospective Observational 
      Study.
PG  - e12758
LID - 10.7759/cureus.12758 [doi]
LID - e12758
AB  - Background Thrombolysis with streptokinase (STK) is the most widely used 
      reperfusion strategy for ST elevation myocardial infarction (STEMI) in India. 
      Achieving full reperfusion as evidenced by thrombolysis in myocardial infarction 
      (TIMI) flow grade 3 in coronary angiography (CAG) is associated with better 
      outcomes. Recent studies show that hematological indices like 
      neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) estimated before 
      thrombolysis could predict TIMI 3 flow. We studied clinical, electrocardiographic 
      and hematological parameters associated with TIMI 3 flow after thrombolysis with 
      STK. Methods We prospectively studied 201 adult patients with STEMI presenting 
      within 12 hours of onset of chest pain. Before thrombolysis, blood sample was 
      collected for estimating NLR and MPV. Timing of CAG after thrombolysis was 
      decided by consultant cardiologists. Patients were followed up for one month 
      after discharge. Results Of 201 patients, 162 (81%) had relief of chest pain and 
      131 (65%) had ST segment recovery of >/=50% at 90 minutes after thrombolysis. CAG 
      was performed within median (IQR) of four (3-5) days after thrombolysis. TIMI 3 
      flow was observed in 112 (56%) patients. NLR and MPV had no significant 
      association with TIMI 3 flow. In multivariable analysis, ST-segment recovery of 
      >/=50% at 90 minutes was associated with TIMI 3 flow (adjusted OR 3.47, 95% CI: 
      1.84-6.53, P= <0.001). Of 198 patients followed up for one month after discharge, 
      13 (6.5%) died. Conclusions In patients with STEMI, ST-segment recovery of >/=50% 
      at 90 minutes after thrombolysis with STK predicted TIMI 3 flow independently. 
      NLR and MPV values were not predictive of TIMI 3 flow.
CI  - Copyright (c) 2021, Raghuram et al.
FAU - Raghuram, Karthik
AU  - Raghuram K
AD  - Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, 
      Puducherry, IND.
FAU - Deepanjali, Surendran
AU  - Deepanjali S
AD  - Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, 
      Puducherry, IND.
FAU - Ananthakrishna Pillai, Ajith
AU  - Ananthakrishna Pillai A
AD  - Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, 
      Puducherry, IND.
LA  - eng
PT  - Journal Article
DEP - 20210118
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7888688
OTO - NOTNLM
OT  - infarct-related artery
OT  - st-elevation myocardial infarction
OT  - timi 3 flow
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/02/23 06:00
MHDA- 2021/02/23 06:01
PMCR- 2021/01/18
CRDT- 2021/02/22 05:56
PHST- 2021/02/22 05:56 [entrez]
PHST- 2021/02/23 06:00 [pubmed]
PHST- 2021/02/23 06:01 [medline]
PHST- 2021/01/18 00:00 [pmc-release]
AID - 10.7759/cureus.12758 [doi]
PST - epublish
SO  - Cureus. 2021 Jan 18;13(1):e12758. doi: 10.7759/cureus.12758.