Intravenous Streptokinase in Acute Myocardial Infarction

1983 ◽  
Vol 17 (5) ◽  
pp. 367-368

Intracoronary streptokinase has been reported to be successful in producing coronary recanalization and lowered morbidity and mortality in acute myocardial infarction patients, when administered shortly after the onset of chest pain. However, intracoronary administration of streptokinase is not practical for most hospitals at present, and intravenous administration would enable treatment of larger numbers of patients and enable the drug to be administered earlier than by the intracoronary route. Available studies have suggested benefits of the intravenous route and results of randomized clinical trials indicate an approximately 20-percent decrease in mortality after intravenous use. Intravenous streptokinase after acute myocardial infarction warrants further investigation.

1996 ◽  
Vol 17 (suppl F) ◽  
pp. 16-29 ◽  
Author(s):  
S. Yusuf ◽  
S. Anand ◽  
A. Avezum ◽  
M. Flather ◽  
M. Coutinho

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Salman A Haq ◽  
John F Heitner ◽  
Terrence J Sacchi ◽  
Sorin J Brener

Antiplatelet therapy is the principal component of the antithrombotic regimen after acute myocardial infarction (AMI). It remains unclear whether additional routine antithrombin therapy with chronic oral anticoagulation (OAC) improves outcomes. Using the Ovid SP and PubMed databases, we performed a comprehensive search for randomized clinical trials comparing warfarin-containing regimens with or without aspirin (OAC) with non-warfarin-containing regimens with or without aspirin (No OAC) for patients with recent AMI, regardless of reperfusion and adjunctive medical therapies provided during hospital stay. The studies had to provide follow-up for at least one month and have mortality as endpoint. Meta-analysis techniques were employed to calculate the relative risk (RR, fixed effect) for all-cause death at the longest interval of follow-up available. Between 1965 and 2006, 32 studies were identified and 11 were included in the meta-analysis. Among 23,803 patients, 13,070 were assigned to OAC and 10,733 to No OAC. The patients were followed for 3–79 months. Death occurred in 1,199 and 1,162 patients, respectively, RR 1.00 (0.995–1.010) (Figure ). After excluding studies without background aspirin therapy, death occurred in 1,057 and 993 patients, respectively (8 studies, RR 1.00 [0.992–1.008]). OAC with or without aspirin background therapy does not reduce mortality after AMI.


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