Vol. 6, Issue 8, Part D (2020)

Abstract
Background: The incidence of MI in India is steadily increasing over the past few decades. Rural to urban ratio in rise in MI cases is around 2:9. This could probably be due to migration from rural to urban cities. Another major problem is the occurrence of MI at a younger age in the Indian population. STEMI is an emergency due to acute total occlusion of an epicardial coronary artery, most often due to atherosclerotic plaque rupture / erosion and subsequent thrombus formation. Compared to UA / NSTEMI, STEMI is associated with a higher in -hospital and 30 day morbidity and mortality. Left untreated, the mortality rate of STEMI can exceed 30% and the presence of mechanical complications (papillary muscle rupture, ventricular septal defect, and free wall rupture) increases the mortality rate to 90%. Keys to treatment of STEMI include rapid recognition and diagnosis, coordinated mobilization of health care resources, and prompt reperfusion therapy. Mortality is directly related to total ischaemia time. Thrombolysis by fibrinolytic agents is still the preferred mode of treatment in India. Only 15%to 20% of patients with MI are able to undergo primary PCI, available in only a few tertiary hospitals in the city limits. Several factors contribute to success of re perfusion in a case of STEMI – age, sex, time taken from onset of pain to treatment, co morbidities like diabetes and systemic hypertension, lifestyle changes like smoking, whether AWMI OR IWMI, etc. So, in the following study, the influence of each of these factors on the success of thrombolysis by Inj. Streptokinase in STEMI patients have been analysed, especially those presenting in less than 3 hours of onset of chest pain.