Killip classification and baseline heart rate can be used to predict streptokinase‑induced hypotension in acute myocardial infarction

Khalid,Karniza; Ahmad,Raja Elina; Lui,Sze Yee; Abidin,Ida Zaliza Zainol

doi:10.3892/wasj.2021.110

Killip classification and baseline heart rate can be used to predict streptokinase‑induced hypotension in acute myocardial infarction

Authors:
- Karniza Khalid
- Raja Elina Ahmad
- Sze Yee Lui
- Ida Zaliza Zainol Abidin
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Affiliations: Department of Physiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia, Department of Emergency and Trauma, Hospital Tuanku Fauziah, Kangar, 01000 Perlis, Malaysia
Published online on: May 21, 2021 https://doi.org/10.3892/wasj.2021.110
Article Number: 39
Copyright: © Khalid et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Streptokinase is the thrombolytic therapy of choice for acute myocardial infarction in hospitals without cardiac facilities. Streptokinase‑induced hypotension is one of the common adverse drug reactions and is usually observed within 30 min of an intravenous streptokinase infusion. The present study aimed to identify predictive clinical parameters for the development of hypotension in patients with acute myocardial infarction. The present retrospective study involved data transcription from National Indicator Approach (NIA) records of acute myocardial infarction recorded between 2015 to 2018. Multivariate analysis was performed to evaluate potential predictors of streptokinase‑induced hypotension and to determine the association between selected clinical variables in patients with streptokinase‑induced hypotension. The present study included a total of 412 patients with acute myocardial infarction administered streptokinase. The majority (n=258, 62.6%) did not develop any complication from the therapy, whereas 109 (26.5%) developed hypotension at 18.5 (interquartile range, 10.00) min from the initiation of therapy. Multiple logistic regression analysis revealed that with every one‑unit increment in the baseline heart rate, the risk of hypotension was reduced by 2.6%. Additionally, patients classified as Killip class III and IV were at an increased risk (5‑fold) of developing hypotension as compared with those classified as Killip I. Therefore, as demonstrated herein, these predictive factors may assist clinicians in identifying susceptible individuals and may encourage vigilance when delivering streptokinase therapy.

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