Background: With respect to the efficacy of thrombolytic agents in the treatment of acute myocardial infarction, the present study was conducted on CCU patients in Shaheed Beheshti hospital in Kashan in 1999-2000. We have determined the efficacy of streptokinase (Sk) based on anti-streptokinase before and after the treatment.

Materials and Methods: For this clinical trial 45 patients with acute myocardial infarction were selected. Their diagnosis was made according to their clinical manifestations as well as EKG and paraclinical studies. Anti-streptokinase was measured by ELISA method. The efficacy of streptokinase was determined by Q wave in EKG.

Results: Of 45 patients, 35 had low and 10 had high level of anti-streptokinase. In 35 patients (28 with low and 10 with high anti-streptokinase) the Q wave remained unchanged following the drug administration. Drug side effects were hypotension (15.5%), bleeding (9%) and allergic reactions (4.5%). No mortality was reported.

Conclusion: With respect to the high prevalence of streptococcal infections in our society, determining the anti-streptokinase level prior to the therapy is recommended. In case of low titer, we suggest streptokinase otherwise other thrombolytic agents should be administered.