Comparison of plasma levels of anticardiolipin and antiphospholipid antibodies in male patients with or without response to streptokinase following acute myocardial infarction

¯Abstract Background: Streptokinase therapy is a medical approach for reperfusion therapy but with variable responses among patients which may be associated with antistreptokinase antibodies or other antibodies such as antiphospholipid or anticardiolipin antibodies. Objective: To compare the blood levels of anticardiolipin and antiphospholipid antibodies and also responses to streptokinase in patients with acute myocardial infarction. Methods: In this case-control study, 52 male patients with myocardial infarction were studied in two groups marked as responsive and non-responsive to streptokinase. The patients responses to streptokinase were measured according to their first ECG and the ECG taken 90-180 minutes following the administration of streptokinase. Reduction of more than half of the ST elevation was considered as being responsive to the treatment. The antibody titers against anticardiolipin and antiphospholipid were further checked by ELISA method. Correlation between each antibody and the response to streptokinase was analyzed using Mann Whitney test (T-test). The relationship between the antibodies mean values and the responses to streptokinase was investigated. Findings: The Mean level of IgG anticardiolipin in responsive patients was significantly lower than the non-responsive group (P=0.009), however, the mean levels of other antibodies such as IgM anticardiolipin, IgG antiphospholipid and the IgM antiphospholipid were statistically insignificant respectively. Conclusion: Based on the results found in our study, it seems that the anticardiolipin antibody has an effect on the response to streptokinase. This antibody inhibits the fibrinolytic effect of plasminogen and eventually results in neutralization of the normal dose of streptokinase.