ST-elevated myocardial infarction (STEMI) is a deadly event caused by acute thrombus in coronary artery that requires immediate reperfusion. However, only a few hospitals can perform Primary PCI, and thrombolytic therapy using Streptokinase are the main strategy for reperfusion in most hospital in Indonesia. The purpose of this study is to determine the severity of infarct-related artery (IRA) coronary in STEMI after streptokinase therapy.

A total of 110 consecutive patients between January 2017 and August 2019 with STEMI treated with Streptokinase were evaluated retrospectively. The patients in whom death before Coronary Angiography (n = 10) and patient not performed Coronary Angiography (CAG) in our center (n = 58) were excluded from the study. A total of 42 patients who underwent CAG after Streptokinase were included in the study.

After streptokinase administration, 42% (n=18) of patients had severe stenosis of IRA, 42% (n=18) patients had significant stenosis, whereas only 16% (n=6) patients had non-significant stenosis. Minor bleeding was found in 35% (n=15) patients, and only 2% (n=1) patient with fatal bleeding. All Patients with non-significant stenosis of IRA had door-to-needle time less than 120 minutes (p<0.05). Meanwhile, the duration of administration streptokinase, the onset of chest pain, and ST resolution after streptokinase administration had no relationship with IRA (p> 0.05).

Most patients with STEMI still had severe or significant stenosis of IRA after treated with Streptokinase, and less significant stenosis of IRA had a relationship with less door-to-needle time.