| Affiliation: | (1) Department of Clinical Pharmacology, BioResearch Ireland, National University of Ireland, Galway, Ireland;(2) Royal College of Surgeons in Ireland, Department of Cardiology, BioResearch Ireland, National University of Ireland, Galway, Ireland;(3) CResT Directorate, St James’s Hospital, National Diagnostics Centre, BioResearch Ireland, National University of Ireland, Galway, Ireland;(4) Conway Institute, University College Dublin, Belfield, Dublin 4 |
| Abstract: | Background Streptokinase resistance may cause suboptimal thrombolytic therapy. Aim To develop a rapid latex-bead assay to detect streptokinase antibodies. Methods Sera were obtained from 16 patients presenting with acute myocardial infarction (MI) before treatment with streptokinase and 1 and 6 months post treatment, and from 100 controls. Sera were assayed for anti-streptokinase antibodies using a functional streptokinase-neutralising assay. Results Streptokinase-neutralising activity was low in controls (54±5U/ml) and patients prior to treatment (101±18), increasing to 2,110±823 and 1,017±169 at 1 and 6 months (mean±SEM). The latex assay had a sensitivity of 94% and a specificity of 93% for detecting individuals with >350U/ml of streptokinase resistance, which is sufficient to neutralise the drug clinically. Conclusions Estimation of streptokinase resistance using an enzyme immunoassay and a latex bead assay correlated well with serum neutralising activity. This assay can rapidly identify patients who have a high level of streptokinase-neutralising activity. |
