IHHP Article: A study of the relationship between anti-prothrombin antibody and response to streptokinase in acute myocardial infarction patients
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A study of the relationship between anti-prothrombin antibody and response to streptokinase in acute myocardial infarction patients

Sedigheh Asgari, Gholam Ali Naderi, Seyed Mohammad Hashemi, Babak Sabet, Seyed Amin Eftekhari, Mohammad Sahari

Introduction
Myocardial infarction (MI) is one of the main causes of morbidity and mortality in the world. Each year, nearly 1.1 million cases of MI occur in United States with a mortality of about 30%, more than half of which occurs before arriving at hospital. Anti-prothrombin antibody is a known risk factor for vascular thrombosis.

Materials and Methods
Twenty-one male MI patients who responded to streptokinase and 21 male MI patients who did not respond to streptokinase were studied. 4.5 milliliters of coagulated and citrated blood was collected for measurement of anti-prothrombin antibody (subgroup IgG) and the samples were transferred to Isfahan Cardiovascular Research Center. Antibody was measured using ELISA. All of the subjects were male individuals with MI, aged between 40 and 65 years. The anti-prothrombin antibody levels and response to streptokinase in each group were analyzed with SPSS and t-Student test.

Results
Mean anti-prothrombin antibody levels in responding and non-responding groups measured 1.1714±0.5772 OD and 1.3095±0.4265 OD, respectively. There was no statistically significant difference between the two groups (P=0.38).

Discussion
There is a 58% probability of non-response to streptokinase in the presence of anti-prothrombin antibody at levels equal to, or higher than 0.8. This probability increases with increase in anti-prothrombin levels. At anti-prothrombin antibody level of 2.2, there is a 100% chance of non-response to streptokinase. There is a 100% probability of responding to streptokinase at anti-prothrombin antibody levels below 0.8. The probability of responding to streptokinase decreases with rise in anti-prothrombin antibody, reaching 57% at an antibody level of 1.2. However, no statistically significant difference was seen between anti-prothrombin antibody levels in the two groups, while mean anti-prothrombin antibody level was higher in the non-responding group. Future studies with larger sample sizes may find significant differences.

Key words
Myocardial Infarction, Anti-prothrombin

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