THROMBOLYSIS IN THE TREATMENT OF ACUTE STROKE: IS THERE A ROLE FOR STREPTOKINASE WHEN TISSUE PLASMINOGEN ACTIVATOR IS NOT AVAILABLE?
Main Article Content
Every year 350,000 people suffer an acute stroke in Pakistan. Treatment of acute stroke has not improvedsignificantly despite the availability of intravenous thrombolysis with tissue plasminogen activator (tPA).The drug is expensive and is offered to a selected few. Streptokinase (SK), a low cost alternativethrombolytic agent, is widely available in Pakistan and is utilized to treat patients with acute coronarysyndromes. Streptokinase was tested in acute stroke in the 1980's and found to be ineffective in ischemicstroke. This is likely due to trial design flaws, rather than the drug itself. Factors that may havecontributed to poor outcomes include a prolonged treatment window, inclusion of patients with establishedinfarction on CT scan, failure to treat excessive arterial pressures, a fixed dose of streptokinase andconcomitant use of antithrombotic medications. Given the lack of therapeutic alternatives we believe that aproperly designed trial in appropriate patient population utilizing stricter inclusion criteria, includingearly treatment with a lower dose of SK is warranted.
How to Cite
Shuaib A, Mohammad A, Sherin A, Butcher K, Khan K, Tariq M, Shuaib U, Khan H, Khan A. THROMBOLYSIS IN THE TREATMENT OF ACUTE STROKE: IS THERE A ROLE FOR STREPTOKINASE WHEN TISSUE PLASMINOGEN ACTIVATOR IS NOT AVAILABLE?. J Postgrad Med Inst [Internet]. 2013 Mar. 10 [cited 2023 May 31];27(2). Available from: https://jpmi.org.pk/index.php/jpmi/article/view/1418
Work published in JPMI is licensed under a
Creative Commons Attribution-NonCommercial 2.0 Generic License.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.