Intravenous streptokinase for acute myocardial infarction resulted in a higher patency rate of the infarct-related artery compared to standard therapy (68.5% vs 44.8%, p=0.003).
RCT (n=368)
randomized
Does intravenous streptokinase improve global and regional systolic function in patients with acute myocardial infarction?
Intravenous streptokinase improves infarct-related artery patency and preserves left ventricular function, including noninfarct regions, in patients with acute myocardial infarction.
Absolute Event Rate: 68.5% vs 44.8%
p-value: p=0.003
The Western Washington Intravenous Streptokinase Trial randomized 368 patients with acute myocardial infarction to receive either intravenous streptokinase or standard therapy. The ventriculograms and coronary angiograms obtained in 170 patients 10.4 +/- 7.4 days after infarction were analyzed to evaluate the effects of thrombolytic therapy on global and regional systolic function. Streptokinase treatment resulted in a higher patency rate of the infarct-related artery (68.5%) than did standard therapy (44.8%) (p = 0.003). Ejection fraction was higher in streptokinase-treated patients (54% vs. 51%, p = 0.056), and the difference was most marked in patients with anterior myocardial infarction (53% vs. 44%, p = 0.03). Regional wall motion was measured by the centerline method and expressed in mean +/- SD motion in 52 normal subjects. There was a trend toward better function of the infarct zone in streptokinase-treated patients (SD, -2.48 vs. -2.70, p = 0.24). Additionally, streptokinase-treated patients had significantly better wall motion of noninfarct areas (SD, 0.36 vs. -0.08, p = 0.02). Treatment effects on function of noninfarct regions were most apparent in the subset of patients with multivessel disease. Thus, intravenous streptokinase preserves left ventricular function in patients with acute myocardial infarction. This benefit includes favorable effects on the function of regions remote from the site of infarction.
Martin et al. (Mon,) conducted a rct in acute myocardial infarction (n=368). Intravenous streptokinase vs. standard therapy was evaluated on Patency rate of the infarct-related artery (p=0.003). Intravenous streptokinase for acute myocardial infarction resulted in a higher patency rate of the infarct-related artery compared to standard therapy (68.5% vs 44.8%, p=0.003).