Key result
Prior streptokinase for AMI linked to elevated antibodies for up to 90 months.
Why the study?
Streptokinase induces immune responses that may cause anaphylaxis or reduce efficacy upon readministration, prompting recommendations against reuse within 1 year; however, longer-term immune profiles remained undefined.
Does prior administration of streptokinase for acute myocardial infarction result in prolonged humoral and cellular immune responses compared to no thrombolytic therapy?
Observational (n=256)
Does prior administration of streptokinase for acute myocardial infarction result in prolonged humoral and cellular immune responses compared to no thrombolytic therapy?
Anti-streptokinase antibodies remain elevated up to 7.5 years after administration, challenging the current recommendation that repeat administration is safe after 1 year.
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The clinical consequences of the findings by Squire et al. are important: there is no time limit beyond which administration of streptokinase is likely to be effective and safe. Thus no patient should ever receive a second treatment with streptokinase.”
Persistent anti-SK antibodies up to 7.5 years warrant caution on repeat dosing; leaves open optimal avoidance interval.
Squire et al. (1999) conducted an observational in Acute myocardial infarction (n=256). Streptokinase vs. Patients with prior acute myocardial infarction who had not received thrombolytic therapy was evaluated on Anti-streptokinase antibodies and T-cell response. Prior administration of streptokinase for acute myocardial infarction resulted in elevated anti-streptokinase antibodies compared to controls at all time periods up to 90 months after treatment.
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