Jemds.com Review Article
J Evolution Med Dent Sci / eISSN - 2278-4802, pISSN - 2278-4748 / Vol. 10 / Issue 29 / July 19, 2021 Page 2212
Role of Coronary Prognostic Index, and Thrombolysis,
in ST Segment Elevation Myocardial Infarction
Amol Andhale
1
, Anuj Varma
2
, Sourya Acharya
3
, Samarth Shukla
4
, Anuj Chaturvedi
5
, Akhilesh Annadatha
6
1, 2, 3, 5, 6
Department of Medicine, Datta Meghe Institute of Medical Sciences (Deemed to Be University),
Sawangi (Meghe), Wardha, Maharashtra, India,
4
Department of Pathology, Datta Meghe Institute of
Medical Sciences (Deemed to Be University), Sawangi (Meghe), Wardha, Maharashtra, India.
ABSTRACT
Angioplasty is considered superior to fibrinolytic therapy in acute myocardial
infarction (AMI) if the patient receives it within the therapeutic window. It is
unclear if such advantages are available for patients who need to travel from a
community hospital to a facility where invasive care is available, since primary
thrombolysis often re-establishes coronary artery blood flow in patients with ST
elevation acute myocardial infarction (STEMI).
At the most severe end of the range of acute coronary syndromes is ST -
segment elevation myocardial infarction (STEMI), which generally occurs when a
fibrin-rich thrombus fully occludes an epicardial coronary artery. The diagnosis of
STEMI is based on clinical features and persistent ST-segment elevation as
evidenced by 12 - lead electrocardiography. Patients with STEMI should have a
quick reperfusion treatment evaluation and a reperfusion strategy should be
performed immediately following contact with the system.
All patients with AMI who had chest pain within 12 hours were evaluated. The
detailed history of chest pain, character, and radiation, had been taken in terms of
duration from the beginning of chest pain in minutes. After 10 minutes, patients
were given 10 mg of sublingual isosorbide dinitrate and repeated ECG. Patients
were excluded if chest pain or ST elevation was resolved after 10 minutes of nitrate
administration. In the analysis only those cases in which chest pain and ST shift
were not resolved following sublingual nitrates. Serum CKMB estimates have been
performed. All patients were treated with 1.5 million IU streptokinase in 100 ml of
normal saline for more than 45 minutes. Clinical assessment for 2 hours every half
hour was done to evaluate: 1. Chest pain reduction in a subjective scale percentage
and to assess changes in the Killip class. 2. Continuous ECG monitoring of
reperfusion rhythm occurrences. Patients are assessed at the end of 2 hours of
follow-up for: a. Percentage reduction in subjective chest pain a. A 12 lead ECG to
identify changes in the ST height c. Repeat CK-MB estimate. Patients with
thrombolysis were classified into two classes on the basis of presence or absence of
SCR at the end of two hours of initiation. Those with successful reperfusion were
grouped into the SCR Group and into the SCR (negative) Group without successful
reperfusion. Coronary prognostic index is a set of questionnaires which
prognosticate the outcome in AMI. This review describes the role of Coronary
Prognostic Index and thrombolysis in patients of STEMI.
KEY WORDS
ECG, AMI, STEMI, Angioplasty
Corresponding Author:
Dr. Amol Andhale,
Resident,
Department of Medicine.
Datta Meghe Institute of Medical
Sciences (Deemed to Be University),
Sawangi (Meghe), Wardha,
Maharashtra, India.
E-mail: dramoljnmc@gmail.com
DOI: 10.14260/jemds/2021/452
How to Cite This Article:
Andhale A, Verma A, Acharya S, et al. Role
of coronary prognostic index, and
thrombolysis, in ST segment elevation
myocardial infarction. J Evolution Med
Dent Sci 2021;10(29):2212-2216, DOI:
10.14260/jemds/2021/452
Submission 18-08-2020,
Peer Review 15-05-2021,
Acceptance 25-05-2021,
Published 19-07-2021.
Copyright © 2021 Amol Andhale et al. This
is an open access article distributed under
Creative Commons Attribution License
[Attribution 4.0 International (CC BY 4.0)]