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Los títulos de antistreptokinasa después de la estreptokinasa intravenosa
1Department of Haematology, University Hospital, Queen's Medical Centre, Nottingham, UK.
Lancet (London, England)
|January 27, 1990
Resumen
Los pacientes que reciben estreptokinasa para el tratamiento del ataque al corazón desarrollan altos niveles de anticuerpos neutralizantes. Estos anticuerpos pueden neutralizar las dosis terapéuticas de estreptokinasa durante hasta un año, lo que afecta las decisiones de retratamiento.
Área de la Ciencia:
- Cardiología Cardiología.
- Inmunología Inmunología.
Sus antecedentes:
- La estreptokinasa es un agente trombolítico utilizado en el infarto agudo de miocardio.
- Los anticuerpos neutralizantes contra la estreptokinasa pueden desarrollarse después del tratamiento.
- El impacto de estos anticuerpos en el nuevo tratamiento es una preocupación clínica.
Objetivo del estudio:
- Para medir los títulos de neutralización de la estreptokinasa en pacientes tratados por infarto agudo de miocardio.
- Para evaluar la duración y el nivel de respuesta de anticuerpo neutralizante.
- Para informar las decisiones con respecto a la readministración de estreptokinasa.
Principales métodos:
- Medición de los títulos de neutralización de la estreptokinasa en 25 pacientes.
- La titulación se realiza antes del tratamiento, a los 3 meses y entre 4,5 y 8,5 meses después del tratamiento.
- Análisis de los niveles de anticuerpos en relación con las dosis terapéuticas.
Principales resultados:
- Los títulos previos al tratamiento fueron bajos en todos los pacientes.
- A los 3 meses, 24 pacientes tenían títulos capaces de neutralizar una dosis terapéutica completa.
- Entre 4,5 y 8,5 meses, 18 de los 20 pacientes mostraron una capacidad de neutralización significativa.
- Los títulos posteriores a los 8 meses oscilaron entre 0,4 y 2,0 millones de unidades.
Conclusiones:
- Los pacientes desarrollan significativos anticuerpos neutralizantes de la estreptokinasa después del tratamiento.
- Estos anticuerpos persisten durante al menos 8 meses, potencialmente hasta un año.
- El nuevo tratamiento con estreptokinasa dentro de los 8-12 meses requiere considerar la capacidad de neutralización plasmática y el ajuste de la dosis.
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