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Streptokinase for the treatment of acute myocardial infarction: a brief review of randomized trials.

Abstract：

:This is a review of the important randomized trials of intracoronary and intravenous streptokinase therapy for treatment of acute myocardial infarction. Trials carried out before 1980 failed to recognize the relations between early coronary reperfusion and myocardial salvage and therefore have not been included in this review. Seven studies on intracoronary streptokinase have been reviewed. The two largest of these studies, the Western Washington trial and the Netherlands trial, show a similar reduction in early mortality. Two other small studies demonstrated a trend toward a reduction in mortality with streptokinase therapy and the other three did not. One small and two large intravenous streptokinase trials are reviewed. Of these, the large GISSI trial in Italy demonstrated a 23% reduction in mortality in patients treated within 3 hours from the onset of symptoms and the Intracoronary Streptokinase in Acute Myocardial Infarction (ISAM) trial showed a similar trend toward reduced mortality. The small Western Washington trial showed an even greater trend toward reduced mortality but this benefit was limited to patients with anterior myocardial infarction who received early therapy. It is concluded that intracoronary and intravenous streptokinase therapy, when initiated within the first 6 hours of acute myocardial infarction, reduces mortality. The therapy is most beneficial for those patients with anterior myocardial infarction and those who can receive therapy within the first 2 to 3 hours from the onset of symptoms.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Kennedy JW

doi

10.1016/s0735-1097(87)80425-4

subject

Has Abstract

pub_date

1987-11-01 00:00:00

pages

28B-32B

issue

5 Suppl B

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(87)80425-4

journal_volume

10

pub_type

临床试验,杂志文章,评审

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