Background: Anterior myocardial infarction is relatively a common problem with increasing prevalence. Controversies have arisen regarding the efficacy of streptokinase or magnesium sulfate therapy. The present study was conducted to determine the efficacy of streptokinase, magnesium sulfate and their combination as well as their side effects in patients with anterior acute myocardial infarction, referring to Shaheed Beheshti hospital in Kashan between 1995-97.

Materials and Methods: It was an existing data type study. Diagnosis was made according to the physical exam, history, EKG findings and elevated enzyme level. Patients were assigned in any of the four groups: Routine drug users (Control n=50), routine drug+streptokinase (n=51), routine drug+magnesium sulfate (n=47), routine drug+magnesium sulfate+streptokinase (Group IV n=48). History of previous MI or disabling disease was our exclusion criteria.

Results: The study population included 153 males and 43 females with the mean age of 61.7±10.54 years. Patients were matched according to the age, sex and blood pressure. The mean days of hospitalization were 12.4±2.8 and 8±1.7 in-group IV and control subjects, respectively. For these groups the mean reduction in blood pressure was 52% and 20.8%, respectively (P<0.05). Patients who received streptokinase as well as magnesium have shown lesser side effects (Hemodynamic, mechanical, pericarditis and aneurysm). Death was reported in 12.2% of patients.

Conclusion: It seems as if combination therapy with magnesium sulfate and streptokinase is associated with better outcomes and less side effects.