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October 1, 1987New England Journal of Medicine

In patients with first infarctions, left ventricular ejection fraction was significantly higher with streptokinase compared to placebo (59 +/- 10.5% vs. 53 +/- 13.5%; P < 0.005).

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Why the study?

Does intravenous streptokinase improve left ventricular function in patients presenting with acute myocardial infarction within four hours of symptom onset?

Population

219 consecutive patients presenting with acute myocardial infarction within four hours of the onset of chest…

Comparison

Streptokinase given intravenously over 30 minutes. vs Placebo given intravenously over 30 minutes…

Design

RCT, randomly assigned, double-blind

Follow-up

3 weeks (cineangiography) and 30 days (survival)

Authors

HWHarvey D. WhiteRNR M NorrisMBMichael Brown

Discussion

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Overview

Streptokinase preserves LVEF after first MI; confirms early thrombolysis benefit and supports its use within 4 hours.

Structured PICO

Does intravenous streptokinase improve left ventricular function in patients presenting with acute myocardial infarction within four hours of symptom onset?

P
Population
219 consecutive patients presenting with acute myocardial infarction within four hours (mean, 3.0 +/- 0.8) of the onset of chest pain.
I
Intervention
Streptokinase (1.5 million units) given intravenously over 30 minutes.
C
Comparator
Placebo given intravenously over 30 minutes. Both groups received heparin (for 48 hours), low-dose aspirin, dipyridamole, and intravenous propranolol if eligible.
O
Outcome
Left ventricular function in patients with first infarctions (measured by left ventricular ejection fraction at three weeks via cineangiography).surrogate

Intravenous streptokinase administered within four hours of acute myocardial infarction significantly improves left ventricular function and short-term survival.

Cite This Study

White et al. (1987) studied this question.

synapsesocial.com/papers/69f179b1b6126e0e7a728163https://doi.org/10.1056/nejm198710013171402
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