Outcome of Thrombolytic Therapy in Acute Coronary Syndrome in Diabetic versus Non-Diabetic Patients

Introduction: Diabetes mellitus (DM) has emerged as a modern epidemic and is at raising trend globally and will continue to be in future. Also, Acute Coronary Syndrome (ACS) is one amongst the major causes of mortality and morbidity globally. The mortality in diabetics is nearly twice as that of non-diabetic. Thus, this study was carried to compare the outcome of thrombolytic therapy in acute coronary syndrome in diabetic versus non-diabetic patients. Objective: To compare the outcome of thrombolytic therapy in acute coronary syndrome in diabetic versus non-diabetic patients. Material and Method: Prospective observational study was undertaken in Rohilkhand Medical College and Hospital, Bareilly including 50 patients presented with ACS admitted in the medical wards from 1st Jan 2018 to 31st Dec 2018. Detailed clinical examination and routine investigations were done. These patients were treated with streptokinase as a thrombolytic agent. ECG was taken on admission and the one after 60 minutes of thrombolysis. The study groups were divided in two i.e. diabetic and non-diabetics. Data was collected, computated and analyzed statistically. Results: 50 cases were enrolled in the study, out of which 31 were male and 19 were female. Two study groups were made one of diabetic and other of non-diabetic for comparison each of 25 cases. Resolution of ST-segment in non-diabetic patients was found in 17 patients out of 25 and in diabetics it was found in patients 11 out of 25. Post fibrinolytic therapy complication were more prevalent in diabetics as compared to those in non-diabetics. Mortality was 12% with diabetics as compared to 4% mortality in non-diabetics. Conclusion: A considerable number of diabetics failed achieve complete reperfusion after thrombolytic therapy, despite the established fact that fibrinolytic therapy benefits in acute myocardial infarction. The mortality and morbidity was more in diabetic when compared with non diabetic after thrombolytic therapy in ACS in our study. Complications after fibrinolytic therapy were more prevalent in diabetics. Thus, one must be aware about this fact and special attention must be given for the better management and care of diabetic myocardial infarction patients