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Effectiveness and comparison of reteplase versus streptokinase thrombolytic agents in the patients of acute myocardial infarction

Sunil Kumar Goel, Ishita Goel, Sandeep Agarwal.


Background: Streptokinase and reteplase are commonly used for thrombolytic therapy in the patients with acute myocardial infarction (AMI). A comparative study was designed to evaluate the effectiveness of both thrombolytic agents.

Objective: The objective of this study was to compare the effectiveness, reperfusion rates, mortality, and safety profile of two thrombolytics (reteplase and streptokinase) in the patients of AMI.

Materials and Methods: The effectiveness of both thrombolytics (reteplase and streptokinase) was compared on AMI patients during hospital stay, at 1-month and 1-year follow-up. The difference of both groups was assessed by Chi-square and Student’s t-test wherever required.

Results: A total of 414 patients of AMI were included in the study. No significant difference was apparent between the effectiveness of both thrombolytics agents at 1-month follow-up of AMI patients. Patients thrombolysed with reteplase showed a significantly low mortality (χ2 = 3.96, d.f. = 1, P = 0.0466) at 1-year post-AMI follow-up. The mean age of patients of reteplase group was 56.7 ± 4.95 years and for patients of streptokinase was 53.2 ± 9.19 years (P < 0.001). The mean age of occurrence of AMI in female was 61.0 ± 8.04 years and in male was 52.9 ± 8.39 years (P < 0.001).

Conclusion: Both thrombolytic agents have similar effectiveness in the treatment of AMI at 1-month post-AMI follow-up. At 1-year follow-up, the study demonstrated the superiority of reteplase over streptokinase. As a conclusion, there is a statistically significant difference in hospital stay of AMI patients thrombolysed with reteplase as compared to streptokinase.

Key words: Reteplase; Streptokinase; Thrombolytic Therapy; Acute Myocardial Infarction

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