Online ISSN: 2515-8260

Keywords : Failed Coronary Reperfusion


Prediction of Failed Coronary Reperfusion after Thrombolytic Therapy in ST - Segment Elevation Myocardial Infarction Patients.

Mahmoud Hassan Shah, MontaserMostafa Al-cekelly, Mohamed Salah Ghareeb, Mona SabryAbd El-Rahman El-Sayed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2784-2794

Background: Around the globe, acute myocardial infarction is the primary cause
of congestive heart failure and death.There is currently no rating system in place
to predict thrombolytic failure in STEMI patients .The aim of the study was to
demonstrate that CHA2DS2-VASc-HS scores would predict missing reperfusion
in STEMI patients on thrombolytic therapy.
Patients and methods: This is a cross sectional prospective study conducted on
70 patients with ST-segment elevation myocardial infarction who were treated with
streptokinase who were grouped into two groups. Group I: STEMI patients with
successful thrombolysis (30 patients). Group II: STEMI Patients with failed
thrombolysis (40 patients). The CHA2DS2-VASc-HSF score was formulated and
Coronary angiography was performed .Gensini score estimation for relative severity
of these lesions and compared to CHA2DS2-VASc-HSF score for achieving the aim
of the study.
Results:There was a statistically significant difference between both group
according to CHA2DS2-VASc-HSF and Gensini score There was strong positive
correlation between CHA2DS2-VASc-HSF score and Gensini score. The cut-off
value of CHA2DS2-VASc-HSF score that can predict failed thrombolytic therapy in
STEMI patients was 4 (AUC= 0.93%, CI 95% ranged from, sensitivity=95 %,
specificity= 76%)
Conclusion:This score may help doctors working in non-PCI hospitals
determine the risk of failed reperfusion using a well-documented formula that takes
into account a variety of risk factors related to the severity of CAD in STEMI
patients.