![]() Existing evidence suggests that full reperfusion as designated by thrombolysis in myocardial infarction (TIMI) flow grade 3 in coronary angiography (CAG) is associated with better myocardial salvage and decreased mortality. The primary aim of thrombolysis is to achieve rapid and complete patency of the infarct-related artery (IRA). However, in many low and middle income countries (LMICs) like India, thrombolysis with streptokinase (STK) remains the most commonly used reperfusion strategy. Primary percutaneous coronary intervention (PPCI) is accepted as the most preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). NLR and MPV values were not predictive of TIMI 3 flow. In patients with STEMI, ST-segment recovery of ≥50% at 90 minutes after thrombolysis with STK predicted TIMI 3 flow independently. Of 198 patients followed up for one month after discharge, 13 (6.5%) died. 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). NLR and MPV had no significant association with TIMI 3 flow. TIMI 3 flow was observed in 112 (56%) patients. CAG was performed within median (IQR) of four (3-5) days after thrombolysis. Of 201 patients, 162 (81%) had relief of chest pain and 131 (65%) had ST segment recovery of ≥50% at 90 minutes after thrombolysis. Patients were followed up for one month after discharge. Timing of CAG after thrombolysis was decided by consultant cardiologists. Before thrombolysis, blood sample was collected for estimating NLR and MPV. We prospectively studied 201 adult patients with STEMI presenting within 12 hours of onset of chest pain. We studied clinical, electrocardiographic and hematological parameters associated with TIMI 3 flow after thrombolysis with STK. Recent studies show that hematological indices like neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) estimated before thrombolysis could predict TIMI 3 flow. Achieving full reperfusion as evidenced by thrombolysis in myocardial infarction (TIMI) flow grade 3 in coronary angiography (CAG) is associated with better outcomes. Thrombolysis with streptokinase (STK) is the most widely used reperfusion strategy for ST elevation myocardial infarction (STEMI) in India.
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