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Repeat thrombolysis

¹Cardiology Department, Royal Brisbane Hospital, Qld.

Australian and New Zealand Journal of Medicine

|December 1, 1993

Summary

This summary is machine-generated.

Repeat thrombolysis with streptokinase (SK) is often ineffective due to persistent antibodies. Tissue plasminogen activator (t-PA) and urokinase remain effective options for patients with myocardial infarction (MI).

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Area of Science:

Cardiology
Immunology

Background:

Myocardial infarction (MI) recurrence is common, necessitating effective re-treatment strategies.
Previous thrombolytic therapy can elicit immune responses impacting subsequent treatments.

Purpose of the Study:

To evaluate the efficacy of repeat thrombolysis in patients with myocardial infarction.
To assess the impact of prior streptokinase administration on repeat thrombolytic therapy.

Main Methods:

Analysis of antibody levels following streptokinase administration.
Review of clinical outcomes for patients receiving repeat thrombolysis.

Main Results:

IgG antibodies against streptokinase persist for up to four years in 50% of patients.

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Repeat administration of streptokinase or anistreplase is generally not recommended beyond the initial few days.

Tissue plasminogen activator and urokinase efficacy is unaffected by prior streptokinase treatment.

Conclusions:

Repeat thrombolysis with streptokinase or anistreplase should be avoided due to antibody interference.
Tissue plasminogen activator and urokinase are viable alternatives for repeat thrombolysis in MI patients with prior streptokinase exposure.