[The clinical aspects of thrombolytic therapy with streptokinase in myocardial infarct]. / Klinicheskie aspekty tromboliticheskoi terapii streptokinazoi pri infarkte miokarda.

We analyzed retrospectively 130 case histories of patients treated with streptokinase for acute MI in our cardiological department. The patients were subdivided into three groups according to the expected success of thrombolysis: successful-50.8% (66 pts), probably successful-19.2% (25 pts) and unsuccessful-30% (39 pts). There was neither difference in age, sex, MI location, nor in risk factor prevalence between the groups. Two factors were found to have a significant impact on 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 initiated, i.e. a circadian influence. The response to the treatment was observed 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 circadian variations in the fibrinolytic system activity.