| Effect of intravenous streptokinase on left ventricular function and early survival after acute myocardial infarction. | |
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MedLine Citation:
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PMID: 2888018 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In a double-blind trial of streptokinase for acute myocardial infarction, 219 consecutive patients presenting with infarction within four hours (mean, 3.0 +/- 0.8) of the onset of chest pain were randomly assigned to treatment with streptokinase (1.5 million units) or placebo, given intravenously over 30 minutes. The primary end point of the study was left ventricular function in patients with first infarctions. Patients who could undergo beta-blockade also received intravenous propranolol. Heparin (for 48 hours) and a combination of low-dose aspirin and dipyridamole were administered to both groups until cineangiography was performed at three weeks. In the patients with first infarctions treated with streptokinase, the left ventricular ejection fraction was 6 percentage points higher (streptokinase vs. placebo, 59 +/- 10.5 vs. 53 +/- 13.5 percent; P less than 0.005), with benefit to patients with either anterior infarction (57 +/- 11.9 vs. 49 +/- 15.9 percent; P less than 0.05) or inferior infarction (60 +/- 9.1 vs. 55 +/- 11.3 percent; P less than 0.05). Left ventricular function was improved regardless of whether concomitant propranolol was given. Survival (at 30 days) was improved with streptokinase: 2 deaths occurred among 79 patients who received this drug, as compared with 12 deaths among 93 patients who received placebo (2.5 vs. 12.9 percent, P = 0.012). Rates of reinfarction (streptokinase vs. placebo, 3 vs. 1 percent) and requirements for surgery or angioplasty (7 vs. 5 percent) were similar in the two groups. We conclude that administration of intravenous streptokinase (1.5 million units) to patients with a first myocardial infarction results in improved left ventricular function and short-term survival. |
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Authors:
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H D White; R M Norris; M A Brown; M Takayama; A Maslowski; N M Bass; J A Ormiston; T Whitlock |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The New England journal of medicine Volume: 317 ISSN: 0028-4793 ISO Abbreviation: N. Engl. J. Med. Publication Date: 1987 Oct |
Date Detail:
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Created Date: 1987-10-20 Completed Date: 1987-10-20 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 850-5 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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administration & dosage Cineangiography Clinical Trials as Topic Double-Blind Method Female Humans Injections, Intravenous Male Myocardial Infarction / drug therapy*, mortality, physiopathology Propranolol / administration & dosage Random Allocation Recurrence Streptokinase / administration & dosage*, adverse effects, pharmacology Stroke Volume* |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 525-66-6/Propranolol; EC 3.4.-/Streptokinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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