| Primary coronary angioplasty versus intravenous streptokinase in acute myocardial infarction: differences in outcome during a mean follow-up of 18 months. | |
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MedLine Citation:
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PMID: 8000624 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Intravenous streptokinase and primary coronary angioplasty are both considered to be effective treatment strategies for patients with acute myocardial infarction. Although primary coronary angioplasty is associated with a high patency rate and a well-preserved left ventricular function, it is not known whether it results in a more favorable clinical outcome in randomized comparisons. METHODS: Clinical data were obtained after a mean follow-up of 18 months (range 6-36 months) after random allocation of 301 patients either to intravenous streptokinase (n = 149) or to primary angioplasty (n = 152). The primary endpoint includes death from cardiac causes and non-fatal reinfarction. The secondary endpoint is a weighted unsatisfactory outcome, one that includes death, stroke, heart failure, shock, ejection fraction lower than 30%, reinfarction, reocclusion and bleeding complications. The need for revascularization procedures was recorded. RESULTS: The relative risk of death from cardiac causes and non-fatal reinfarction in the streptokinase group was 6.1 (95% confidence interval 2.9-12.7) compared with the angioplasty group. There was a lower weighted unsatisfactory outcome score of 0.13 +/- 0.29 in patients randomly assigned to angioplasty compared with 0.34 +/- 0.33 in patients randomly assigned to streptokinase (P < 0.001). Coronary angioplasty or coronary artery bypass grafting, or both, were performed more often in the streptokinase group, with a relative risk of 2.1 compared with patients randomly assigned to angioplasty (95% confidence interval 1.5-3.2). CONCLUSION: Clinical outcome in patients with acute myocardial infarction after a mean follow-up of 18 months was more favorable in patients randomly assigned to primary angioplasty compared with those receiving intravenous streptokinase. |
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Authors:
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F Zijlstra; M J de Boer; J P Ottervanger; A L Liem; J C Hoorntje; H Suryapranata |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Coronary artery disease Volume: 5 ISSN: 0954-6928 ISO Abbreviation: Coron. Artery Dis. Publication Date: 1994 Aug |
Date Detail:
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Created Date: 1995-01-24 Completed Date: 1995-01-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 707-12 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Hospital de Weezenlanden, Zwolle, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Chi-Square Distribution Disease-Free Survival Female Follow-Up Studies Humans Infusions, Intravenous Male Middle Aged Myocardial Infarction / drug therapy, mortality, therapy* Prognosis Proportional Hazards Models Risk Streptokinase / administration & dosage, therapeutic use* Survival Rate Thrombolytic Therapy* |
| Chemical | |
Reg. No./Substance:
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EC 3.4.-/Streptokinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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