Streptokinase is the main thrombolytic used for the management of ST Elevated Myocardial Infarctions (STEMI) in Sri Lanka. We assessed the efficacy of streptokinase in restoring myocardial perfusion following acute STEMI. One hundred and eight patients were studied. Sixty eight (56%) patients responded to streptokinase. Forty five (41.7%) had anterior STEMI and 20 (44.4%) responded (p=<0.001). Forty four had inferior STEMI and 32 (72.7%) responded (p=0.007). Fifteen had antero-lateral STEMI and 13.3% responded. Time from the onset of pain to arrival at hospital was 137 in responders and 339 minutes in non responders (p=0.004). Eight (11.8%) responders and four (10%) non responders were on aspirin. Thirty two (47.1%) responders and 16 (40%) non responders were smokers. Twenty (29.4%) responders and 9 (22.5%) non responders were having diabetes mellitus. Considerably higher percentage responded to streptokinase. Inferior myocardial infarctions have significantly high reperfusion rates. Delayed hospital admission had a major impact in the non responders.
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