Document Detail


Effect of intravenous streptokinase on left ventricular function and early survival after acute myocardial infarction.
MedLine Citation:
PMID:  2888018     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  317     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1987 Oct 
Date Detail:
Created Date:  1987-10-20     Completed Date:  1987-10-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  850-5     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / 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:
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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