Streptokinase: Biochemistry and Phamacokinetics
Streptokinase, one of the first thrombolytic agents to be discovered, has now been used in many hundreds of thousands of patients with acute myocardial infarction. The drug was first discovered in 1933 by William Tillet, who called it fibrolysin , but only in 1947 were the first tests done on humans to lyse chronic thoracic empyemas, with considerable success. The intravenous administration of streptokinase was delayed because of difficulties in purifying the protein. In the 1960s, Behringwerke AG and Kabi Pharmacia made the drug available for widespread therapeutic use. The first trials using streptokinase in patients with acute myocardial infarction, published between 1978 and 1988, showed a significant survival benefit compared with conservative treatment or placebo [2, 3, 4].
KeywordsAcute Myocardial Infarction Fibrinolytic Activity Thrombolytic Agent Intravenous Streptokinase Suspected Acute Myocardial Infarction
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- 4.ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet 2:349, 1988.Google Scholar
- 19.Gruppo Italiano per lo Studio della Streptochinasi nell’Infarto Miocardico. GISSI-2: Randomised trial of intravenous alteplase versus intravenous streptokinase in acute myocardial infarction. Lancet 336: 65, 1990.Google Scholar
- 21.Collins R, MacMahon S, Flather M, Baigent C, Remvig L, Mottensen S, et al. Clinical effects of anticoagulant therapy in suspected acute myocardial infarction: Systematic overview of randomised trials. Br Med J 313:652, 1996.Google Scholar
- 24.Andreotti F, The TIMI 9B and GUSTO IIb trials and the “thrombin hypothesis.” J Thromb Thrombolys 1997, in press.Google Scholar