Impaired hepatic function tests after streptokinase for acute myocardial infarction

Comparing the results of livers function tests for 50 patients with acute myocardial infarction, of which 25 patients received strepto- kinase and the other 25 patients matched in age, sex, and clinical presentation did not receive streptokinase, on admission and after one week. There was a significant increment in the serum total bilirubin, alkaline phosphotase and GGT in both groups after one week. While SGPT was no significantly elevated in the control group while it was very highly significantly elevated at one week in SK group. Both group had comparable results after one week with not significant difference. So the results of this study concluded that hepatic dysfunction was more marked after SK administration. The exact mechanism of these dysfunction are not yet fully elucidated

Enhanced thrombolytic efficacy and reduction of infarct size by simultaneous infusion of streptokinase and heparin

Thirty patients with recent onset acute myocardial infarction admitted to Coronary Care Unit of Ain Shams University Hospital. They divided into two groups. Group I patient received Simultaneous infusion of Streptokinase and heparin and group II patients received streptokinase followed by heparin two hours later. Group 1 showed signs of faster and shorter reperfusion time than group II, with rapid relief of chest pain and earlier peaking of serum creatinine phosphokinase enzyme with lower peak value. As well as rapid resolution of ECG criteria of ischemia and high incidence of reperfusion arrhythmia in group I than in group II. In the same time the segmental wall motion abnormalities were lower in group I than in group II and also the wall motion score index. Group I had better left ventricular function and higher ejection fraction than group II. Thus, the present study showed that simultaneous infusion of streptokinase and heparin early in acute myocardial infarction is better than subsequent infusion of heparin after streptokinase because the former resulted in more rapid recanalization of the infarct related artery, faster repefusion of the affected myocardium, smaller infarcts and better left ventricular function than the latter