INVESTIGATING THE HYPOTENSIVE EFFECTS OF INTRAVENOUS STREPTOKINASE AMONG PATIENTS WITH MYOCARDIAL INFARCTION AT GANGARAM HOSPITAL LAHORE

Background/ Objective: A fall in blood pressure frequently occurs during the infusion of streptokinase in patients with myocardial infarction. Thus, hypotension is a common among the several adverse drug reactions induced by streptokinase infusion. However, there is paucity of evidences locally available to prevent and manage these reactions. The present study investigates the hypotensive effects alongside the other adverse drug reactions during streptokinase infusion in patients with myocardial infarction.

Design and subjects: This study has been conducted among the patients with MI visiting cardiac emergency of Sir Ganga Ram Hospital (SGRH), Lahore. The data have been collected retrieved from N=60 patients who were given streptokinase for thrombolytic therapy. Systolic blood pressure measurements and corresponding intervals during the occurrence of this reaction have obtained and observed.

Results: Hypotension was reported as the most common adverse drug reaction that occurred among (n=31%) followed by hemorrhagic stroke (30%), recurrent chest pain (25%), bleeding (13%), and coughing (13%). Streptokinase induced hypotension occurred at a median of 15(13) minutes after starting streptokinase infusion. Hypotensive episode recovered in a median duration of 15(10) minutes with appropriate interventions. Apart from temporarily withholding streptokinase, most patients required a combination of fluid therapy and vasopressor support to restore systolic blood pressure.

Conclusion: The risk and benefit of administering streptokinase must be assessed and effective strategies can be implemented to ensure whether streptokinase treatment is safe to all myocardial infarction patients. Moreover, the early intravenous administration of streptokinase in the hospital setting leads to a reduced rate of major cardiovascular events compared to delayed administration. However, mortality rates were not significantly affected. Secondary prevention should be targeted on modifiable demographic and psychosocial risk factors of myocardial infarction.

Keywords: Streptokinase, Myocardial Infarction, Hypotension.