Abstract
OBJECTIVE--To determine the development of titres of streptokinase (SK) neutralising antibodies after a single dose of SK, to establish when titres decrease to levels at which a second dose might be effective. DESIGN--Analyses of blood samples taken from patients at intervals after SK administration. SETTING--Australian public hospital. PATIENTS--104 patients with acute myocardial infarction who were treated with SK and 27 controls who were not. OUTCOME MEASURE--SK neutralising antibodies were measured once in each of the 27 controls and on 166 occasions in the 104 treated patients. RESULTS--Titres of SK neutralising antibodies rose after SK administration but returned to control levels by 2 years. CONCLUSIONS--SK might be effective again as a thrombolytic agent as early as 2 years after a single dose. These results are at variance with most previously published data and the reasons for this are not clear. Data evaluating patency rates after standard doses of streptokinase in patients with increased titres of neutralising antibodies are necessary before re-exposure to streptokinase can be recommended.
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Selected References
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- Brügemann J., van der Meer J., Bom V. J., van der Schaaf W., de Graeff P. A., Lie K. I. Anti-streptokinase antibodies inhibit fibrinolytic effects of anistreplase in acute myocardial infarction. Am J Cardiol. 1993 Aug 15;72(5):462–464. doi: 10.1016/0002-9149(93)91143-6. [DOI] [PubMed] [Google Scholar]
- Buchalter M. B., Suntharalingam G., Jennings I., Hart C., Luddington R. J., Chakraverty R., Jacobson S. K., Weissberg P. L., Baglin T. P. Streptokinase resistance: when might streptokinase administration be ineffective? Br Heart J. 1992 Nov;68(5):449–453. doi: 10.1136/hrt.68.11.449. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Elliott J. M., Cross D. B., Cederholm-Williams S. A., White H. D. Neutralizing antibodies to streptokinase four years after intravenous thrombolytic therapy. Am J Cardiol. 1993 Mar 15;71(8):640–645. doi: 10.1016/0002-9149(93)91003-z. [DOI] [PubMed] [Google Scholar]
- Fears R., Ferres H., Glasgow E., Standring R., Hogg K. J., Gemmill J. D., Burns J. M., Rae A. P., Dunn F. G., Hillis W. S. Monitoring of streptokinase resistance titre in acute myocardial infarction patients up to 30 months after giving streptokinase or anistreplase and related studies to measure specific antistreptokinase IgG. Br Heart J. 1992 Aug;68(2):167–170. doi: 10.1136/hrt.68.8.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- HAWKEY C., HOWELL M. THE LABORATORY CONTROL OF THROMBOLYTIC THERAPY. J Clin Pathol. 1964 May;17:287–291. doi: 10.1136/jcp.17.3.287. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lee H. S., Yule S., McKenzie A., Cross S., Reid T., Davidson R., Jennings K. Hypersensitivity reactions to streptokinase in patients with high pre-treatment antistreptokinase antibody and neutralisation titres. Eur Heart J. 1993 Dec;14(12):1640–1643. doi: 10.1093/eurheartj/14.12.1640. [DOI] [PubMed] [Google Scholar]
- Patel S., Jalihal S., Dutka D. P., Morris G. K. Streptokinase neutralisation titres up to 866 days after intravenous streptokinase for acute myocardial infarction. Br Heart J. 1993 Aug;70(2):119–121. doi: 10.1136/hrt.70.2.119. [DOI] [PMC free article] [PubMed] [Google Scholar]
- White H. D., Cross D. B., Williams B. F., Norris R. M. Safety and efficacy of repeat thrombolytic treatment after acute myocardial infarction. Br Heart J. 1990 Sep;64(3):177–181. doi: 10.1136/hrt.64.3.177. [DOI] [PMC free article] [PubMed] [Google Scholar]