Thrombolytic treatment and complement activation.
Details of possible complement activation in acute myocardial infarction (AMI) and the in vivo effects of fibrinolytic agents on this activation are not yet known. We measured complement activation in 40 patients with AMI: 20 were treated with streptokinase, and 20 did not receive any fibrinolytic agent. Anaphylatoxin C4a, C3a and membrane attack complexes SC5b-9 increased about 10-fold (p < 0.0001) during streptokinase infusion. There were no increases in complement catabolic products in AMI patients not treated with streptokinase. Significant transient leukopenia (-29.5%, 7.0 SEM, p = 0.001) and a drop in systolic pressure (-29%, 3.4 SEM, p < 0.0001) occurred after 15 min of streptokinase infusion simultaneously with the peak of anaphylatoxins in plasma.
Agostoni
A
A
Istituto di Medicina Interna, Università degli Studi, IRCCS Ospedale Maggiore di Milano.
Gardinali
M
M
Frangi
D
D
Cugno
M
M
Cafaro
C
C
Conciato
L
L
Sponzilli
C
C
Salmoirago
E
E
D000706:Anaphylatoxins / Q000032:analysis; D001794:Blood Pressure; D003167:Complement Activation / Q000187:drug effects; D015926:Complement C3a / Q000032:analysis; D015934:Complement C4a / Q000032:analysis; D015936:Complement C5a / Q000032:analysis; D015938:Complement Membrane Attack Complex; D003165:Complement System Proteins / Q000032:analysis; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D007124:Immunoenzyme Techniques; D007262:Infusions, Intravenous; D007958:Leukocyte Count; D009203:Myocardial Infarction / Q000188:drug therapy / Q000276:immunology; D011863:Radioimmunoassay; D013300:Streptokinase / Q000008:administration & dosage / Q000494:pharmacology; D015912:Thrombolytic Therapy
D000706:Anaphylatoxins; D015938:Complement Membrane Attack Complex; D006023:Glycoproteins; C047610:SC5b-9 protein complex; D015926:Complement C3a; D015934:Complement C4a; D015936:Complement C5a; D003165:Complement System Proteins; D013300:Streptokinase