Document Detail


Lack of influence of pretreatment antistreptokinase antibody on efficacy in a multicenter patency comparison of intravenous streptokinase and anistreplase in acute myocardial infarction.
MedLine Citation:
PMID:  1636574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Antistreptokinase antibodies present in patients as a result of previous streptococcal infections might theoretically influence the thrombolytic response to streptokinase or anistreplase. The potential influence of antibody, measured as antigen binding to immunoglobulin G, was investigated in a randomized, double-blind, multicenter patency comparison of intravenous streptokinase (1.5 million units/60 minutes) and intravenous anistreplase (30 units/2 to 5 minutes) in patients with acute myocardial infarction. Antibody results were evaluated in 333 patients (from a total study population of 370 patients) less than 76 years of age with ECG evidence of ST segment elevation who could be treated within 4 hours of the onset of symptoms. Variations in pretreatment circulating levels of antibody did not influence angiographically defined early coronary patency rates (Thrombolysis in Myocardial Infarction grade 2 or 3 perfusion, measured at a mean of 140 minutes after therapy was begun) for either streptokinase or anistreplase. Similarly the lytic response represented by systemic plasminogen activation and measured as changes in plasma plasminogen and fibrinogen levels after dosing (at mean times of 90 minutes and 24 hours) was not correlated with baseline antibody levels. Furthermore, pretreatment antibody was not a risk factor for poor outcome in response to streptokinase or anistreplase (reocclusion within 24 hours, in-hospital death, or stroke) and did not correlate with hypotension or allergic-type reactions recorded as adverse events. In conclusion, within the population limits defined by the inclusion and exclusion criteria of the study (patients were excluded if they had received streptokinase or anistreplase within the previous 6 months), pretreatment antistreptokinase immunoglobulin G is not a significant determinant of the efficacy response to streptokinase or anistreplase.
Authors:
R Fears; J Hearn; R Standring; J L Anderson; V J Marder
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  124     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-08-24     Completed Date:  1992-08-24     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  305-14     Citation Subset:  AIM; IM    
Affiliation:
SmithKline Beecham Pharmaceuticals, Epsom, Surrey, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Anistreplase / therapeutic use*
Coronary Vessels / drug effects
Double-Blind Method
Female
Humans
Immunoglobulin G / immunology*
Male
Myocardial Infarction / drug therapy*,  epidemiology
Streptokinase / immunology*,  therapeutic use*
Thrombolytic Therapy*
Treatment Outcome
Vascular Patency / drug effects
Grant Support
ID/Acronym/Agency:
NHLBI 30616/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Immunoglobulin G; 81669-57-0/Anistreplase; EC 3.4.-/Streptokinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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