Streptokinase resistance: when might streptokinase administration be ineffective?

Buchalter, M. B.; Suntharalingam, Ganesh; Jennings, Ian; Hart, Christina; Luddington, Roger; Chakraverty, R; Sk, Jacobson; Weissberg, PL; Tp, Baglin

doi:10.1136/hrt.68.11.449

Cited by 35 publications

(11 citation statements)

References 4 publications

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“…Buchalter et al showed that exposure to SK within the previous two years was a contraindication to further SK administration because of persisting anti-SK antibodies. 8 The population in that study had non-significant levels of anti-SK antibodies before SK thrombolysis.…”

Section: ''Resources and Infrastructure Mitigate Against Conducting Wmentioning

confidence: 94%

Antistreptokinase antibodies: implications for thrombolysis in a region with endemic streptococcal infection: Table 1

Blackwell

Hollins²,

Gilmore³

et al. 2005

J Clin Pathol

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Aims:To determine antistreptokinase antibody (anti-SK) titres in patients with the acute coronary syndrome from communities with endemic group A streptococcal infection because of the implications for streptokinase (SK) thrombolysis.Methods:Anti-SK titres were determined using a standard method in 47 consecutive SK naive patients, presenting to the Mt Isa Hospital emergency department, Australia, with an acute coronary syndrome. Both indigenous and non-indigenous subjects were enrolled. Antistreptolysin O (ASOT) and anti-DNAse B (ADB) titres were also determined.Results:Indigenous patients were more likely to have anti-SK antibodies (p < 0.001) than the non-indigenous cohort. Anti-SK antibody titres also correlated well with ASOT/ADB titres.Conclusions:Anti-SK antibodies are highly prevalent in SK naive indigenous patients presenting with the acute coronary syndrome. Streptokinase should not be used for thrombolysis in populations with endemic group A streptococcal infection.

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Section: ''Resources and Infrastructure Mitigate Against Conducting Wmentioning

confidence: 94%

Antistreptokinase antibodies: implications for thrombolysis in a region with endemic streptococcal infection: Table 1

Blackwell

Hollins²,

Gilmore³

et al. 2005

J Clin Pathol

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“…Systemically administered streptokinase generates a systemic antibody response that can neutralise later administration of streptokinase. [135][136][137][138][139][140][141][142] It is not yet known whether intrapleurally administered fibrinolytic agents produce a similar response. In the absence of such data it is advisable to manage patients as if they had received their initial fibrinolytic systemically, with urokinase or tissue plasminogen activator (TPA) being used for later myocardial infarction or pulmonary embolism.…”

Section: Intrapleural Fibrinolytic Drugsmentioning

confidence: 99%

BTS guidelines for the management of pleural infection

Davies

Gleeson

Davies

2003

Thorax

263

159

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“…These antibodies persist for years after the treatment and make these patients resistant to any further treatment by SK. Though the exact duration for which these antibodies persist is not known, it is at the least 2 years 8 9. Accordingly, both the American College of Cardiology and European Society of Cardiology guidelines mention a previous treatment with SK as a contraindication for SK use in patients with STEMI 3 4…”

Section: Discussionmentioning

confidence: 99%

Antistreptokinase antibodies and the response to thrombolysis with streptokinase in patients with acute ST elevation myocardial infarction

2012

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Background and objective A large number of patients with ST elevation myocardial infarction (STEMI) continue to receive streptokinase (SK) in the developing countries. High levels of antistreptokinase (ASK) antibodies can result in failure of thrombolysis. This study was conducted to assess the presence of ASK antibodies in the general population and its effect on the outcome of thrombolysis with SK.

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Streptokinase resistance: when might streptokinase administration be ineffective?

Abstract: Objective-(a) To

Cited by 35 publications

References 4 publications

Antistreptokinase antibodies: implications for thrombolysis in a region with endemic streptococcal infection: Table 1

Antistreptokinase antibodies: implications for thrombolysis in a region with endemic streptococcal infection: Table 1

BTS guidelines for the management of pleural infection

Antistreptokinase antibodies and the response to thrombolysis with streptokinase in patients with acute ST elevation myocardial infarction

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