Role of thrombolytic therapy in young adult smokers with acute ST-elevation myocardial infarction
| Autor: | Syed Ata Ur Rahman, Siddarth Mathur, Lakshmi S. Dandu, Divya Pandiri, Vived Kumar Turai, Shiva Kumar Yerra |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
education.field_of_study
medicine.medical_specialty biology business.industry medicine.medical_treatment Population Percutaneous coronary intervention Odds ratio medicine.disease Fibrin Thrombin Thrombolytic drug Internal medicine medicine biology.protein Cardiology Young adult Thrombus education business medicine.drug |
| Zdroj: | Journal of Indian College of Cardiology. 3:99-103 |
| ISSN: | 1561-8811 |
| Popis: | Introduction STEMI is a major cause of cardiovascular mortality worldwide. Smoking seems to be the most common risk factor seen in both young and the old population. Atherosclerotic plaques are more commonly seen in older population. In young smoking adults the clots are not atherosclerotic. As smoking causes endothelial injury along with “sticky phenomenon”, where the fibrin sticks together in presence of thrombin and forms clots. The thrombolytic efficiency lays in its specificity to fibrin. This makes thrombolytic drugs the preferential treatment in young adults due to their clots (fibrin and thrombin) than older patient's atherosclerotic plaques (cholesterol, fibrin and thrombin). Method Only patients diagnosed with acute STEMI and treated with Thrombolytic therapy were included in this study. Results Our study showed that TLT was effective in recanalising the infarct related artery in the young adult smokers when compared to the old adults with acute STEMI. Age is a statistically significant variable ( p p = 0.056). And when we look at the group of young adults, the effect of smoking on number of recanalisations has an odds ratio of 2.57, which can be interpreted as, smokers are 2.57 times are likely to recanalise the infarct related artery when compared to non-smokers. Conclusion Although Percutaneous Coronary Intervention (PCI) has been proven beneficial over TLT in management of acute STEMI, thrombolytics are recanalising the younger patients better than the older patients. TLT has a special place in young smokers as it targets the fibrin breakdown and therefore accounts for higher recanalisation rates, as most of their clots are due to thrombus formation made of fibrin and thrombin. |
| Databáze: | OpenAIRE |
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