: Association between admission mean platelet volume with electrocardiographic ST resolution and prognosis of acute ST segment elevation myocardial infarction (STEM) in patients treated with streptokinase

Abstract

The immediate therapeutic goal of reperfusion therapy is to restore full antegrade flow in the infarct-related epicardial coronary artery , as well as to achieve adequate myocardial perfusion at tissue level. Estimation of ST segment resolution in 90 min after reperfusion therapy electrocardiogram is one of the noninvasive methods for evaluation of tissue perfusion. addition to conventional risk factors for CAD,platelet size and activity manifested with MPV (mean platelet volume) influence acute myocardial infarction prognosis. the purpose of this study was to evaluate association between admission mean platelet volume with electrocardiographic ST resolution and prognosis of acute ST segment elevation myocardial infarction (STEMI) in patients treated with streptokinase. Methods: We enrolled 191 consecutive patients admitted to the ED with the diagnosis of first acute ST segment elevation myocardial infarction presenting within 12 hours from symptom onset,and eligible for reperfusion therapy. Intravenous peripheral blood samples was taken from all patients at the time of hospitalization .all patients received streptokinase in the usual dose regimen. patients under wen t resting high-quality 12-lead electrocardiogram recordings to estimate the sum of ST segment elevation before and 90 min after streptokinase and their differences that called STR. Patients were classified into two groups:those with STR≥50%(complet STR) and those with STR<50%(incomplete STR).also patients were classified into two groups : those with MPV ≥8.2 (high MPV) and those with MPV<8.2(low MPV) Results: Admission MPV was higher in patients with <50% STR than patients with >50% STR (8.8fl vs 7.7 fl respectively, p=0.00). Also age,presence of DM,pain to needle time,subgroup MI(ant or inf), presence of MVD, admission CK and CTNI values were determinated factors in response to fibrinolytic therapy.In-hospital complications (VT and VF,HF,shock) and global mortality rate was high in patients with <50%ST-segment resolution (p=0.00). also patient who suffered from complicated STEMI(VT and VF,HF,shock and RBBB),had higher level of MPV(p<0.05).