STATE OF THE ART PAPER
Pathophysiology of streptokinase-induced hypotension in acute myocardial infarction: a systematic review of clinical evidence
| 1 | Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia |
| 2 | Clinical Research Centre, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia, Malaysia |
| 3 | Department of Internal Medicine, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia, Malaysia |
| 4 | Emergency and Trauma Department, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia, Malaysia |
Submission date: 2020-12-29
Final revision date: 2021-03-05
Acceptance date: 2021-03-06
Publication date: 2021-04-16
Arch Med Sci Atheroscler Dis 2021;6(1):85–94
KEYWORDS
Myocardial infarctionStreptokinaseblood viscosityvascular resistancecomplement activationstreptokinasemyocardial infarction
TOPICS
Coronary artery diseaseExtensive reviews, narrative reviews, reviewsClinical studies, clinical trialBasic researchMolecular biologyMyocardial InfarctionSystematic reviews, meta-analyses
ABSTRACT
Introduction:
Despite the common occurrence of streptokinase-induced hypotension among patients with acute myocardial infarction, the underlying pathophysiology remains obscure and poorly understood. Our study aimed to pool clinical evidence on the potential mechanism of streptokinase-induced hypotension through a systematic review of the literature.
Material and methods:
We conducted literature search from Medline, Scopus and Web of Science on clinical studies related to streptokinase-induced hypotension.
Results:
Our search yielded 972 citations. After removal of duplicates, 878 articles were screened for eligibility, of which 856 papers were excluded due to various reasons. Of the remaining 22 articles retrieved with full texts, eight relevant articles were selected for final analysis. Three themes emerged as the proposed mechanisms of streptokinase-induced hypotension, including (i) reduction in total peripheral resistance, (ii) complement activation, and (iii) dismissal of hypotheses involving other intermediaries.
Conclusions:
Our findings suggest that the underlying mechanism of streptokinase-induced hypotension lies primarily in the reduction in total peripheral resistance.
Despite the common occurrence of streptokinase-induced hypotension among patients with acute myocardial infarction, the underlying pathophysiology remains obscure and poorly understood. Our study aimed to pool clinical evidence on the potential mechanism of streptokinase-induced hypotension through a systematic review of the literature.
Material and methods:
We conducted literature search from Medline, Scopus and Web of Science on clinical studies related to streptokinase-induced hypotension.
Results:
Our search yielded 972 citations. After removal of duplicates, 878 articles were screened for eligibility, of which 856 papers were excluded due to various reasons. Of the remaining 22 articles retrieved with full texts, eight relevant articles were selected for final analysis. Three themes emerged as the proposed mechanisms of streptokinase-induced hypotension, including (i) reduction in total peripheral resistance, (ii) complement activation, and (iii) dismissal of hypotheses involving other intermediaries.
Conclusions:
Our findings suggest that the underlying mechanism of streptokinase-induced hypotension lies primarily in the reduction in total peripheral resistance.
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