title: Anti-streptokinase titers and response to streptokinase treatment in Pakistani patients.
abstract: In order to investigate whether anti-streptokinase (anti-SK) antibody titers have any effect on response to standard dose (1.5 million units) streptokinase (SK) therapy in patients with acute myocardial infarction, anti-SK titers in plasma were determined in 97 such patients. These patients were classified as "responders" or "non-responders" on the basis of a criteria which involved resolution of chest pain in less than 90 min after the start of thrombolysis, greater than 50% reduction of ST segment elevation in two contiguous leads showing maximum elevations in a 12-lead tracing, reperfusion arrythmias and slope of increase in creatine kinase over a 90-min period after initiation of thrombolysis. Anti-SK antibody levels in plasma were determined in these patients as well as in 50 normal healthy subjects by dissolution of clot method. Mean+/-S.D. anti-SK levels among responders, non-responders and normal healthy subjects were found to be 0.21+/-0.12, 0.25+/-0.22 and 0.21+/-0.15 million units, respectively. A comparison of these mean values by one-way ANOVA revealed no statistical difference (P=0.68). However, when compared with the reported values for a Western population, these values were found to be significantly higher (P<0.03). Whereas, compared to the reported values for an Indian population, these were significantly lower (P<0.0001). 42% of patients appeared to have responded to SK treatment, while 21% were found to be non-responders. There was no association between response to SK and anti-SK titers in these patients suggesting that the standard dose of SK (1.5 million units) may be quite appropriate for the Pakistani population requiring SK treatment for the first time.
authors.affiliation: Department of Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan.
authors.forename: Khawar A
authors.initials: KA
authors.lastname: Kazmi
authors.forename: M
authors.initials: M
authors.lastname: Perwaiz Iqbal
authors.forename: Abdul
authors.initials: A
authors.lastname: Rahbar
authors.forename: Naseema
authors.initials: N
authors.lastname: Mehboobali
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000276:immunology; D009500:Neutralization Tests; D010154:Pakistan; D013300:Streptokinase / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D013997:Time Factors
chemical_list: D000907:Antibodies, Bacterial; D005343:Fibrinolytic Agents; C014338:antistreptokinase; D013300:Streptokinase