CLINICAL ASPECTS OF THROMBOLYTIC THERAPY WITH STREPTOKINASE IN ACUTE MYOCARDIAL-INFARCTION (MI)

We analyzed retrospectively 130 case histories of patients treated wit h streptokinase for acute MI in our cardiological department. The pati ents were subdivided into three groups according to the expected succe ss of thrombolysis: successful - 50.8% (66 pts), probably siiccessfill - 19.2% (25 pts) and unsuccessful - 30% (39 pts). There was neither d ifference ill age, sex, MI location, nor in risk factor prevalence bet ween the groups. Two factors were found to have a significant impact o n thrombolysis success: time lag between onset of pain and treatment ( streptokinase) initiation (the shorter this period was the better were the results, p=0.002) and the time of day when the treatment was init iated, i.e. a circadian influence. The response to the treatment was o bserved much more frequently during evening hours (55.6% versus 18.5%, p=0.001). it is concluded that there are circadian variations in the response to streptokinase therapy which are related most probably to c ircadian variations in the fibrinolytic system activity.