Faisal Mutib, Muhammad Arif Nadeem, Tariq Waseem, M Tariq Masood Khan Niazi, Abdul Wadood Khalid, Abdul Hafeez Khan.
Non-Invasive markers of reperfusion following Thrombolysis in Acute Myocardial Infarction.
Pak J Cardiol Jan ;10(4):108-14.

Several non-invasive markers of reperfusion after thrombolytic therapy including resolution of chest pain, resolution of ST segment elevation on ECG, biochemical markers and cardiac imaging have been found very useful for its assessment. We observed time taken for relief from chest pain, resolution of ST segment elevation >50% from peak elevation or rhythm disturbances and for accelerated release of CK-MB, after thrombolytic therapy, as noninvasive markers of reperfusion. Thirty patients with acute myocardial infarction (AMI), presenting within six hours of the onset of symptoms with no contraindication to thrombolysis were studied. Frequent clinical inquires were made about pain relief. Twelve leads ECG was recorded every half an hour for first two hours and hourly for next two hours. Blood samples for CK-MB at 0,60,120 and 240 minutes after therapy taken for analysis. Seventy three percent patients fulfilled the ECG and CK-MB criteria of successful reperfusion. Resolution of pain and ST segment occurred within 30 minutes of abrupt rise in CK-MB level in 66.67% patients. This study showed that successful reperfusion can be ascertained on the basis of simple non-invasive markers in majority of patients.

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