Dysrhythmias Induced by Streptokinase Infusion in Patients with Acute Myocardial Infarction Admitted to Cardiac Care Units in the Northwest of Iran

Objective: Currently, the most common cause of death in the world is cardiovascular disease, particularly myocardial infarction. Myocardial infarction is caused by reducing or cutting off the blood supply to the heart muscle due to obstruction caused by the presence of plaque or thrombus. The first step for the treatment of acute myocardial infarction is using thrombolytic drugs. By the analysis of plaque and removing the blockage, the blood flows to the affected area again. The most important thrombolytic agent is streptokinase; however, in addition to its therapeutic effect it also has some complications and by identifying them mortality and disability can be prevented. The present study aimed to investigate the most common arrhythmia after infusion of streptokinase in patients with acute myocardial infarction (AMI). Materials and Methods: This research was a descriptive study. The study population included patients admitted to the cardiac care unit of Shahid Madani Hospital, Tabriz, Iran, with a diagnosis of AMI from September 2012 until March 2014. Data were collected by using a checklist and the findings of the study were analyzed by SPSS software. Results: Of the 116 hospitalized patients, 78 (67.5%) were male and 37 (32.5%) were female, and the largest percentage of infected patients was in the age group of 60-70 years [n = 38 (33%)]. Regarding cardiac risk factors, 57 (49%) of patients were hyperlipidemic, 36 (31%) were diabetic, 34 (30%) had high blood pressure, 25 (21%) were smokers, and 21 (18%) had a positive family history of cardiac problems. Patients who were admitted with a diagnosis of AMI, in 53 (46%) cases had streptokinase injection, and in 86 (74%) complications had occurred during drug injection; 87 (75%) patients had dysrhythmia and 29 (25%) had bleeding. Common dysrhythmia was premature ventricular contraction (PVC) with 90 (78.2%) cases. Moreover, 53 (46%) patients had slow ventricular tachycardia (VT), 18 (16%) had premature atrial contraction (PAC), and 5 (4%) had other arrhythmias. Mean of creatine phosphokinase (CPK) was 604, lactic dehydrogenase (LDH) 565.4, creatine phosphokinase mb (CKmb) 58.2, and cardiac troponin I (CTNI) 8.7. Conclusion: By the timely referral of patients and knowledge of the nurses about complications of streptokinase, its side effects can be prevented.