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
| Autor: | A P Rae, J.M.A. Burns, F G Dunn, W S Hillis, R Fears, E. Glasgow, H Ferres, J D Gemmill, R. Standring, Karen Hogg |
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| Rok vydání: | 1992 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors genetic structures Streptokinase Drug Resistance Myocardial Infarction Drug resistance Antibodies Immunoglobulin G Double-Blind Method medicine Humans Thrombolytic Therapy cardiovascular diseases Prospective Studies Myocardial infarction Dosing Prospective cohort study Aged biology Anistreplase business.industry Articles Middle Aged medicine.disease Surgery Titer Anesthesia Antibody Formation cardiovascular system biology.protein Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Heart. 68:167-170 |
| ISSN: | 1355-6037 |
| DOI: | 10.1136/hrt.68.8.167 |
| Popis: | Objective —To examine the induction of antistreptokinase antibodies after giving streptokinase or anistreplase to patients with acute myocardial infarction. Design —Patients were randomly allocated to receive either 1·5 × 10 6 IU, streptokinase or 30U anistreplase in a double blind study. Blood samples were collected immediately before treatment and subsequently at intervals up to 30 months; plasma samples were assayed for streptokinase resistance titre (functional assay) and streptokinase binding by IgG (microradioimmunoassay). Setting —Cardiology department in a general hospital. Patients —128 consecutive eligible patients. Samples were collected for up to one year according to a prospective design: a subsection of 47 patients was selected for intensive study over the first 14 days. After one year, all available patients (67) were sampled on one further occasion. Results —Antibody responses to streptokinase and anistreplase were similar. Streptokinase resistance titres exceeded pretreatment concentrations five days after dosing, and values peaked at 14 days. By 12 months after dosing, 92% of resistance titres (n = 84) had returned to within the pretreatment range. Antistreptokinase IgG concentrations also exceeded baseline concentrations within five days and peaked at 14 days. Half of the individual values had returned to within the pretreatment range by 12 months (n = 84) and 89% by 30 months (n = 18). Conclusion —Although we cannot be sure of the clinical significance, because of the increased likelihood of resistance due to antistreptokinase antibody, streptokinase and anistreplase may not be effective if administered more than five days after an earlier dose of streptokinase or anistreplase, particularly between five days and 12 months, and increased antistreptokinase antibody may increase the risk of allergic-type reactions. |
| Databáze: | OpenAIRE |
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