The evaluation of streptokinaz rezistance, a fibrinolytic agent in high risk profile for coronary artery disease living upper firat region

AMI has high mortality and is caused by sudden obstruction of coronary blood flow due to some reasons. Intracoronary thrombosisi is the most common reason in STEMI and because of this, thrombolytic therapy is the most easy way to establish the reperfusion. Streptokinase is the first agent in this class. Anti-streptococcal antibodies which induced by prior streptococcal infection neutralizes streptokinase and decreases its effectiveness in STEMI. We aimed to investigate the streptokinaz antibody titer in people who didn?t take streptokinase and high risk profile for coronary artery disease living in Upper Fırat Region (Elazığ, Bingöl, Tunceli, Muş).A total of 80 patients (40 from rural, 40 from urban areas) admitted to Firat University Medical Faculty Hospital Cardiology Clinic and have high risk criterias according to ESC guideline. Anti-SK antibody levels were determined in the plasma of patients and controls by the method used by Jalihal and Morris [4]. Briefly, SK (Sigma, USA)Anti-Streptokinase antibody levels were significantly higher in rural areas when compared to urban areas (160±100 thousand unit vs 80±50 thousand unit). The maximum and minimum level of streptokinase antibody titer were 708.000 unit vs 37.000 unit in rural and 310.000 unit vs 32.000 unit in urban areas. The streptokinase antibody levels were significantly higher in rural areas (p<0,001).Antibody levels were lower when compared to prior studies. This may be explained by increasing antibiotic usage and improvements of sosioeconomic level in our developing country. We conclude that 1.5 million unit stretokinase is applicable in AMI patients according to these antibody titers in this region (Upper Fırat Region).Key Words: Coronary artery disease, Thrombolysis, streptokinase resistance, streptokinase antibody.