Can anti-streptokinase antibody predict myocardial infarction outcomes after streptokinase treatment?

BACKGROUND The aim of this study was finding the association between anti- Streptokinase (SK) levels based on previous streptococcus infection and the clinical outcome of acute myocardial infarction (AMI) among Iranian patients after SK treatment. METHODS In this prospective study, 31 consecutive patients presented to the emergency room of a referral university hospital within six hours of the onset of symptoms of AMI were recruited over a 3-year period (2007-2010). Blood samples for the analysis of the effect of neutralizing antibodies to SK assays were obtained immediately on arrival at the hospital. In-hospital and out-hospital clinical outcome defined as including return of typical chest pain after 48 hours, appearance of complex arrhythmia after 24 hours, maximum CPK serum concentration during first three days of admission, Left Venticular Ejection Fraction (EF) on the last day of admission, surgical interventions (CABG, PTCA), re-MI and re-admission due to cardiac problems during the one-year follow-up. RESULTS Overall, 31 patients (7 female, 24 male with the mean age of 56.83 +/- 2.21 years) were included in this study. The recurrence of typical ischemic chest pain 48 hours after AMI, appearance of complex arrhythmia during the admission to CCU and 24 hours after AMI, maximum CPK serum concentration during the first three days of admission, and left EF on the last day of admission were not significantly different between the two compared groups (p > 0.05). CONCLUSION According to this study, previous exposure to streptococcal infections may not reduce the efficacy of a single dose of SK and it does not seem necessary that its titer be measured before SK administration.