Compare the Effectiveness of Thrombolysis and Percutaneous Coronary Intervention in Myocardial Infarction Patients
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Background: Acute myocardial infarction requires timely reperfusion to limit myocardial injury and reduce early complications. Primary percutaneous coronary intervention is generally preferred when rapidly available, whereas streptokinase-based thrombolysis remains an important reperfusion option in settings where PCI access is delayed or unavailable. Objective: To compare in-hospital clinical outcomes among patients with acute myocardial infarction treated with percutaneous coronary intervention and streptokinase-based thrombolysis. Methods: This multicenter retrospective observational study included 100 patients with acute myocardial infarction treated in healthcare centers in Lahore, Pakistan. Patients were divided into two equal groups according to reperfusion modality: PCI group (n = 50) and streptokinase group (n = 50). Outcomes included cardiogenic shock, arrhythmia, in-hospital mortality, duration of hospital stay, and left ventricular ejection fraction. Categorical outcomes were compared using exact tests, and continuous outcomes were compared using independent samples t-test. Results: Cardiogenic shock was recorded in 0/50 patients in the PCI group and 22/50 patients in the streptokinase group, while arrhythmia was recorded in 0/50 and 15/50 patients, respectively. Both differences were statistically significant. In-hospital mortality was 0/50 in the PCI group and 1/50 in the streptokinase group, with no statistically significant difference. Hospital stay and ejection fraction were also comparable between groups. Conclusion: PCI was associated with fewer recorded in-hospital complications, particularly cardiogenic shock and arrhythmia, compared with streptokinase-based thrombolysis. Mortality, hospital stay, and ejection fraction did not differ significantly. These findings should be interpreted cautiously because of the retrospective non-randomized design and limited baseline comparability data.
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