Streptokinase

The activation of the coagulation cascade is multifactorial. Clot formation can occur due to venous stasis, hypercoagulable states such as malignancy, or endothelial injury. These conditions activate the coagulation cascade, which ultimately leads to the development of a fibrin clot. Streptokinase is FDA approved in the treatment of acute ST-segment elevation myocardial infarction, arterial thrombosis or embolism, deep vein thrombosis, pulmonary embolism, and arteriovenous cannula occlusion. It is also on the WHO Model List of Essential Medicines (EML). It is not currently commercially available in the United States. Streptokinase was the first thrombolytic agent brought to the market to treat acute myocardial infarction. The ISIS-2 trial with more than 30000 patients demonstrated streptokinase’s ability to reduce mortality compared to the standard treatment. The research showed that streptokinase could lyse over 50% of a thrombus in 5 to 10 minutes.