Abstract |
Streptokinase and anistreplase are antigenic and their administration often leads to antibody formation. These can cause allergic reactions and/or neutralization of streptokinase with resulting suboptimal treatment. Currently, streptokinase re-administration is considered appropriate for up to 5 days and from 1 year after a previous dose. Antistreptokinase antibody and neutralization titres (NT) were measured in three groups of patients to determine if this practice is appropriate: 1. (early)--36 patients whose titres were measured for at least 5 days after thrombolysis; 2. (late)--57 patients who received thrombolysis 12-54 months previously; 3. (controls)--182 consecutive suspected myocardial infarction patients (without previous exposure to thrombolysis). Results were as follows (mean +/- SEM): 1. (early)--the antibody and/or NT were raised by day 4 in 19.4% of the patients. One patient could have neutralized 1.97 million units (MU) of streptokinase by day 4. (Day 4--antibody 1:39 +/- 11, NT 0.19 +/- 0.05 MU; day 5--1:136 +/- 41 and NT 0.7 +/- 0.43 MU respectively.) 2. (late)--23 patients (40%) had either antibody titres > or = 1:160 and/or NT > 1.5 MU. (12-23 months--antibody 1:243 +/- 43, NT 0.63 +/- 0.15 MU; 24-35 months--1:98 +/- 31 and 0.69 +/- 0.22 MU; 36-54 months--1:87 +/- 14 and 0.54 +/- 0.12 MU.) All titres were significantly higher than the controls (antibody 1:25 +/- 3, NT 0.14 +/- 0.01 MU, P < 0.01). After streptokinase or antistreplase, antibodies are raised from 4 days to at least 54 months. It would seem prudent to avoid their re-administration during this time interval.
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Authors | H S Lee, S Cross, R Davidson, T Reid, K Jennings |
Journal | European heart journal
(Eur Heart J)
Vol. 14
Issue 1
Pg. 84-9
(Jan 1993)
ISSN: 0195-668X [Print] England |
PMID | 8432298
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Antibodies
- Anistreplase
- Streptokinase
- Hydrocortisone
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Topics |
- Anistreplase
(administration & dosage, immunology)
- Antibodies
(analysis)
- Female
- Humans
- Hydrocortisone
(administration & dosage)
- Infusions, Intravenous
- Male
- Middle Aged
- Myocardial Infarction
(immunology, therapy)
- Neutralization Tests
- Premedication
- Streptokinase
(administration & dosage, immunology)
- Thrombolytic Therapy
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