Background New Zealand Māori have some of the highest rates of Group A streptococcal infection (GAS) in the world. GAS elevates titres of antistreptokinase (SK) neutralising antibodies and may induce resistance to SK.
Methods Anti-SK titres were measured in 180 patients presenting with symptoms consistent with an acute coronary syndrome to three New Zealand rural hospitals, selected because they provide care for patients from communities with different socio-economic and ethnic mixes (Māori proportions varying between 6% and 67%).
Findings Compared with the community with the lowest proportion of Māori, patients in the community with the highest proportion of Māori had mean anti-SK titres that were 2.8 times higher (p=0.05). They were 2.5 times more likely to have a high anti-SK titre (33% vs 13% p=0.035).
Interpretation Alternatives to reperfusion with SK should be the first-choice therapy in hospitals serving communities with high rates of GAS such as some predominantly Māori and Pacific Island communities.
- myocardial ischaemia
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Funding The Heart Foundation; The Healthcare Otago Charitable Trust.
Competing interests None.
Ethics approval Ethics approval was provided by the New Zealand Multi-Region Ethics Committee, New Zealand Ministry of Health.
Provenance and peer review Not commissioned; externally peer reviewed.