Streptokinase (SK) infusion is not considered an established technique for the treatment of acute myocardial infarction (MI). Many reports indicate that both intravenous and intracoronary administration of SK results in reperfusion of the occluded artery in the majority of patients with coronary thrombosis under certain circumstances. The goal of SK therapy, however, is not only to reestablish the coronary blood flow of the occluded artery, but to salvage myocardial cells destined to undergo necrosis and therefore to reduce the extent of infarction. The effect of reduction of infarct on subsequent mobidity and mortality in patients is unknown at this time and the demonstration of restored antegrade coronary flow is not sufficient to establish that SK administration by either route is a safe and effective treatment for some or all patients with MI. The studies reported in the literature appear to demonstrate and support the clinical effectiveness of SK therapy to reestablish patency of coronary occulusions. Because the clinical applications and methods of SK therapy have varied there is a need to establish the optimal dosage and duration of infusion for this therapy. The AMA, ACC and the AHA all agree that while SK therapy is highly promising, such therapy cannot yet be considered safe and effective.
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