A COMPARATIVE STUDY ON EFFICACY AND SAFETY OF STREPTOKINASE AND RETEPLASE IN PATIENTS WITH MYOCARDIAL INFARCTION IN A TERTIARY CARE TEACHING HOSPITAL

MUTHULAKSHMI R; JAMUNARANI R; JANANI L; SOWMINI K

doi:10.22159/ajpcr.2025v18i1.52907

Authors

MUTHULAKSHMI R Department of Pharmacology, Dhanalakshmi Srinivasan Institute of Medical Sciences and Hospital, Perambalur, India
JAMUNARANI R Department of Pharmacology, SRM Medical College Hospital and Research Centre, Kattankulathur, India
JANANI L Department of Community Medicine, Dhanalakshmi Srinivasan Institute of Medical Sciences and Hospital, Perambalur, India.
SOWMINI K Department of Pharmacology, Dhanalakshmi Srinivasan Institute of Medical Sciences and Hospital, Perambalur, India

DOI:

https://doi.org/10.22159/ajpcr.2025v18i1.52907

Keywords:

Acute myocardial infarction, Streptokinase, Reteplase

Abstract

Objectives: This study compares the efficacy, safety, and cost-effectiveness of streptokinase and reteplase in treating patients with acute myocardial infarction (AMI) at SRM Hospital. A total of 86 patients were divided into two groups, each receiving either streptokinase or reteplase, with outcomes tracked over a 3-month period.

Methods: Over the course of 3 months, the results of 86 patients who were split into two groups and given either reteplase or streptokinase were monitored.

Results: The duration of hospital stays (6.05 days vs. 9.79 days) and the time it took to relieve symptoms (4.58 h vs. 8.74 h for streptokinase) were both significantly shortened by reteplase, according to the results. However, streptokinase was found to be more cost-effective. Both treatments showed similar increases in creatine phosphokinase (CPK) and CPK-MB biomarkers post-thrombolysis, but reteplase demonstrated superior efficacy. While reteplase was associated with a higher incidence of bleeding, streptokinase had more cases of hypotension and hypersensitivity. No significant mortality or morbidity was observed during the study period.

Conclusion: This study highlights the clinical advantages of reteplase over streptokinase, despite its higher cost.

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References

Fuster V, Narula J, Kelly BB. Promoting global cardiovascular and cerebrovascular health. Mt Sinai J Med. 2012;79(6):625-31. doi: 10.1002/msj.21344, PMID 23239201

Manasa MT, Ramanamurthy KV, Bhupathi PA. Electrospun nanofibrous wound dressings: A review on chitosan composite nanofibers as potential wound dressings. Int J App Pharm. 2023 Jul;15(4):1. doi: 10.22159/ijap.2023v15i4.47912

Available from: https://blog.medicounsel.com/2016/09/12/heart-disease-statistics-India-2016

Herlitz J, Blohm M, Hartford M, Hjalmarsson A, Holmberg S, Karlson BW. Delay time in suspected acute myocardial infarction and the importance of its modification. Clin Cardiol. 1989;12(7):370-4. doi: 10.1002/clc.4960120704, PMID 2743624

National Heart Lung and Blood Institute. Morbidity and Mortality: Chartbook on Cardiovascular, Lung, and Blood Diseases. United States: National Heart Lung and Blood Institute; 1992.

Suri A, Tincy S, Ahsan S, Meier P, editors. Thrombolysis in Myozardial Infraction. Novel Strategies in Ischemic. Heart Disease. London: Intechopen; 2012. p. 123-34.

Goodman and Gilman’s The Pharmacological Basis of Therapeutics. Kumar and Clark’s Clinical Medicine. 7th and 12th ed. United States: Macmillan; 2017. p. 752.

Armstrong PW, Collen D. Fibrinolysis for acute myocardial infarction: Current status and new horizons for Pharmacological reperfusion, Part 1. Circulation. 2001;103(23):2862-6. doi: 10.1161/01.cir.103.23.2862, PMID 11401946

White HD, Van de Werf FJ. Thrombolysis for acute myocardial infarction. Circulation. 1998;97(16):1632-46. doi: 10.1161/01. cir.97.16.1632, PMID 9593569

Rovelli FC, Vita DE, Feruglio GA, Lotto A, Selvini A, Tavazzi L, et al. Effectiveness of intravenous Thrombolytic treatment in acute myocardial infarction [Gruppo Italiano per lo studio della streptochinasi nell’ Infarto Miocardico [GISSI]]. Lancet. 1986;327(8478):397-402.

Sharma HL, Sharma KK. Principles of Pharmacology. 2nd ed. Telangana: Paras Medical Publisher; 2011, reprint 2015. p. 682-3.

Product Information. Streptase (Streptokinase). West Borough, MA Astrapharmaceutical Prod; 1991 Mar.

Noble S, McTavish D. Reteplase: A review of its Pharmacological properties and clinical efficacy in the management of acute myocardial infarction. Drugs. 1996;52(4):589-605. doi: 10.2165/00003495- 199652040-00012, PMID 8891469

Doughty M, Mehta R, Bruckman DS, Das S, Karavite D, Tsai T, et al. Acute myocardial infarction in young- university of Michigan experience. Am Heart J. 2002;143(1):56-62. doi: 10.1067/mhj.2002.120300

Sadiq Shah S, Noor L, Shah SH, Shahsawar, Ud Din S, Awan ZA, et al. Myocardial infarction in young vs old adults; Cal characteristics and angiographic features. J Ayub Med Coll Abbotabad 2010;22(2):187-90.

Wilson AC, Husan Shao Y, Cosgrove NM. Changing age distribution of acute myocardial infarction in men and women in New Jersey hospital. Circulation. 2007;116:11-832.

Canto JG, Rogers WG, Goldberg RJ. Association of age and sex with MI symptom presentation. JAMA. 2012. Feb 22;307(8):13-22.

Pramod MP, Mulay Surekha P, Hanchate Milind S. Acute myocardial infarction among young adults in India: Clinical profile and risk factors. Int J Innov Res Med Sci (IJIRMS). 2016 Nov;1(9):366-71.

von Eyben FE, Bech J, Madsen JK, Efsen F. High prevalence of smoking in young patients with myocardial infarction. J R Soc Health. 1996 Jun;116:153-6.

Pelluri R, Vanitha Rani N, Ramesh M, Kannan G, Palani T. Safety and efficacy of streptokinase, Reteplase and Tenecteplase in patients with acute stelevated myocardial infarction in an intensive cardiac care unit of a tertiary care teaching hospital. Int J Pharm Bio Sci. 2014 Oct;5(4):29-38.

Kumolosasi E, Wong Sin W, Wee CE, et al. The use of thrombolytic agents in acute myocardial infarction (AMI) patients. Int J Pharm Pharm Sci. 2013;5(2):31-43.

Rama M, Miraci MI, Petrela E, Malaj L. Comparison of Reteplase double-bolus administration with streptokinase in acute myocardial infarction. Int J Pharm Sci. 2015 Jun 1;7(6):180-3.