Why the study?
Does reteplase reduce mortality at 30 days compared to alteplase in patients with acute myocardial infarction presenting within 6 hours?
Population
15,059 patients presenting within 6 hours after the onset of symptoms with ST-segment elevation or…
Comparison
Reteplase, in two bolus doses of 10 MU each… vs Accelerated infusion of alteplase, up to 100 mg…
Design
RCT, Randomly assigned in a 2:1 ratio
Follow-up
30 days
Key result
Reteplase did not provide any additional survival benefit compared with alteplase for acute myocardial infarction, with 30-day mortality of 7.47% vs 7.24% (OR 1.03; 95% CI 0.91-1.18; P=0.54).
Authors
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Supports alteplase as standard for acute MI; challenges angiographic surrogates as predictors of survival.
RCT (n=15,059)
2:1
Yes
Does reteplase reduce mortality at 30 days compared to alteplase in patients with acute myocardial infarction presenting within 6 hours?
Effect estimate: OR 1.03 (95% CI 0.91 to 1.18)
Absolute Event Rate: 7.47% vs 7.24%
p-value: p=0.54
Reteplase did not provide any additional survival benefit over an accelerated infusion of alteplase in the treatment of acute myocardial infarction.
The Global Use of Strategies to Open Occluded Coronary Arteries Investigators (1997) conducted an RCT in Acute Myocardial Infarction (n=15,059). Reteplase vs. Alteplase (accelerated infusion up to 100 mg over 90 minutes) was evaluated on Mortality at 30 days (OR 1.03, 95% CI 0.91 to 1.18, p=0.54). Reteplase did not provide any additional survival benefit compared with alteplase for acute myocardial infarction, with 30-day mortality of 7.47% vs 7.24% (OR 1.03; 95% CI 0.91-1.18; P=0.54).
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