title: Antistreptokinase antibodies: implications for thrombolysis in a region with endemic streptococcal infection.
abstract: OBJECTIVE
  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.
authors.affiliation: Mount Isa Hospital, Mount Isa, Queensland 4825, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Blackwell
authors.forename: A
authors.initials: A
authors.lastname: Hollins
authors.forename: G
authors.initials: G
authors.lastname: Gilmore
authors.forename: R
authors.initials: R
authors.lastname: Norton
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D000075202:Contraindications; D003327:Coronary Disease / Q000188:drug therapy; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011793:Queensland / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology / Q000276:immunology*; D013297:Streptococcus pyogenes; D013300:Streptokinase; D015912:Thrombolytic Therapy / Q000379:methods*
chemical_list: D000907:Antibodies, Bacterial; C014338:antistreptokinase; D013300:Streptokinase