Left Ventricular Longitudinal Strain Following Revascularization in Acute ST Segment Elevation Myocardial Infarction: A Comparison of Primary Angioplasty and Streptokinase Based Pharmacoinvasive Strategy

Bedier, Ahmed; Rizq, Ahmed Elsayed; Shehab Eldin, Mohamed Bayoumi; Teima, Sally Magdy

doi:10.21608/ejhm.2023.282504

Left Ventricular Longitudinal Strain Following Revascularization in Acute ST Segment Elevation Myocardial Infarction: A Comparison of Primary Angioplasty and Streptokinase Based Pharmacoinvasive Strategy

Document Type : Original Article

Authors

department of cardiology , mansoura university , Egypt

10.21608/ejhm.2023.282504

Abstract

Background: Two-dimensional speckle-tracking echocardiography (2D STE) has been proven to be more accurate than prognostic metrics such as the left ventricular ejection fraction (LVEF) and wall motion score index (WMSI).
Aim: To contrast the effectiveness of primary percutaneous coronary intervention (PCI) versus Streptokinase based pharmacoinvasive technique in ST elevation myocardial infarction (STEMI) patients.
Patients and methods: In this observational cross section research, 100 patients with acute STEMI were enrolled. They were then divided into two groups: Group A, which included 50 patients who underwent primary PCI as a reperfusion strategy, and Group B, which included 50 patients who underwent pharmacoinvasive technique, which involved streptokinase IV infusion, over the course of a year from November 2020 to November 2021. In order to evaluate the main outcome, which was LV systolic function, all patients had a thorough medical history review, physical examination, 12-lead surface ECG, and echocardiogram (2D global longitudinal strain [GLS] utilizing speckle tracking echocardiography [STE]. Results: Pre-intervention GLS showed no statistically substantial variation between the two groups (p=0.768), however post-treatment GLS showed statistically substantial variations between the two groups (p=0.004) and regarding change (%) GLS (p˂ 0.001).
Conclusion: Primary PCI remains the best option for resolving ischemia. When compared to IV streptokinase treatment, direct coronary angioplasty exhibited a substantial clinical advantage. To treat the myocardial infarction, it was superior to streptokinase based pharmacoinvasive therapy.

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