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Thrombolytic treatment and complement activation

A Agostoni1, M Gardinali, D Frangi

  • 1Istituto di Medicina Interna, Università degli Studi, IRCCS Ospedale Maggiore di Milano.

Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna
|July 1, 1994
PubMed
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Streptokinase treatment for acute myocardial infarction (AMI) activates the complement system, leading to anaphylatoxins and potential side effects. This complement activation was not observed in untreated AMI patients.

Area of Science:

  • Cardiovascular Medicine
  • Immunology

Background:

  • Complement activation in acute myocardial infarction (AMI) and its modulation by fibrinolytic agents remain unclear.
  • Understanding these interactions is crucial for optimizing AMI treatment.

Purpose of the Study:

  • To investigate complement system activation in AMI patients treated with streptokinase.
  • To compare complement activation between treated and untreated AMI patients.

Main Methods:

  • Measured plasma levels of anaphylatoxins (C4a, C3a) and membrane attack complexes (SC5b-9) in 40 AMI patients.
  • Patients were divided into two groups: 20 treated with streptokinase and 20 untreated.

Main Results:

  • Streptokinase infusion caused a 10-fold increase in C4a, C3a, and SC5b-9 (p < 0.0001).

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  • No significant increase in complement products was observed in untreated AMI patients.
  • Leukopenia and decreased systolic pressure coincided with peak anaphylatoxin levels during streptokinase infusion.

    • Conclusions:

    • Streptokinase treatment for AMI induces significant complement activation.
    • This activation is associated with transient leukopenia and hypotension, suggesting a role in treatment-related adverse events.