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Selection of thrombolytic therapy for individual patients: development of a clinical model. GUSTO-I Investigators.

Abstract：

:We developed a logistic regression model with data from the GUSTO-I trial to predict mortality rate differences in individual patients who received accelerated tissue plasminogen activator (TPA) versus streptokinase treatment for acute myocardial infarction. A nomogram was developed from a reduced version of this model that approximated the underlying risk of patients treated with streptokinase, and thus the benefit of TPA. The 30-day mortality rate with accelerated TPA was 0.063 versus 0.073 with streptokinase and subcutaneously administered heparin and 0.074 with streptokinase and intravenously administered heparin. No baseline patient characteristics were significantly associated with a different relative effect of TPA. Older patients and those with anterior infarction, higher Killip classification (except Killip class IV), lower blood pressure, and increased heart rate had the greatest absolute benefit with accelerated TPA. Patients with acute myocardial infarction who had more high-risk characteristics derived a greater absolute benefit from treatment with accelerated TPA versus streptokinase.

journal_name

Am Heart J

journal_title

American heart journal

authors

Califf RM,Woodlief LH,Harrell FE Jr,Lee KL,White HD,Guerci A,Barbash GI,Simes RJ,Weaver WD,Simoons ML,Topol EJ

doi

10.1016/s0002-8703(97)70164-9

subject

Has Abstract

pub_date

1997-06-01 00:00:00

pages

630-9

issue

6

eissn

0002-8703

issn

1097-6744

pii

S0002870397001890

journal_volume

133

pub_type

临床试验,杂志文章,随机对照试验

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