Exploring the Efficacy of Streptokinase and Tenecteplase: Comparing Thrombolytic, Pharmaco-Invasive Therapy and Primary PCI in ST-Elevated Myocardial Infarction Patients of Bangladesh

Objectives: The number of deaths from cardiovascular diseases (CVDs) is alarming, making them a major threat to global health. In low- and middle-income nations like Bangladesh, heart attacks and strokes are particularly common and cause the majority of these deaths. Data on ST-segment elevation myocardial infarction (STEMI) in Bangladesh is still scarce and rife with statistical errors, despite the country being among the most affected by CVD in South Asia. In order to fill this knowledge gap and provide guidance for the best possible management of STEMI, this study will compare and aggregate existing data on reperfusion strategies, such as thrombolysis, Primary Percutaneous Coronary Intervention (PPCI), and the Pharmaco-invasive (PI) strategy. Methods: In primary healthcare settings, reperfusion techniques for ST-segment elevation myocardial infarction (STEMI) were assessed in this prospective observational study conducted in Bangladesh. We enrolled 599 patients, ages 18 to 75, who had STEMI symptoms within 6 hours. They received primary percutaneous coronary intervention (PCI) (C = 45), pharmaco-invasive therapy with streptokinase (A2 = 35) and tenecteplase (B2 = 49), or thrombolytic therapy with streptokinase (A1 = 271) or tenecteplase (B1 = 199). Laboratory tests, medical history, demographics, and treatment allocation data were gathered. ESC guidelines were followed by the in-hospital management. T-tests were used in the statistical analysis. Results: Disparities in treatment outcomes were found when the study examined cardiovascular interventions in Bangladesh. Compared to group A1 (streptokinase), group B1 (tenecteplase) had greater success rates and fewer complications. Pharmaco-invasive methods, on the other hand, produced results that were comparable for A2 and B2. The revascularisation rates of the pharmaco-invasive groups varied, but group B1 showed noticeably fewer post-MI complications than group A1. Different groups had different mortality rates. A1 had a marginally higher mortality rate, but follow-up at 30 days revealed similar re-hospitalisation rates. This highlights the necessity of specialised interventions for the management of cardiovascular diseases, particularly in Bangladesh. Conclusions: This study concludes that in order to effectively manage ST-segment elevation myocardial infarction (STEMI) in Bangladesh, tailored interventions are essential. When compared to streptokinase, the use of tenecteplase in thrombolytic therapy showed encouraging results, such as improved ST resolution, increased successful reperfusion, and a significant decrease in chest pain. Pharmaco-invasive techniques also produced similar outcomes. These results highlight the need for more research to improve STEMI treatment strategies in comparable settings, demonstrating a sense of urgency and concern for enhancing patient care in these environments.