Key result
Anistreplase significantly decreased diameter stenosis compared to placebo (11% vs 3%, p=0.008) in patients with unstable angina, but yielded no clinical improvement and increased bleeding.
Why the study?
Does anistreplase improve angiographic and clinical outcomes in patients with unstable angina?
Population
n=159 patients without a previous myocardial infarction, with a typical history of unstable angina, and ECG…
Comparison
Anistreplase administered after baseline… vs Placebo administered after baseline angiography
Design
RCT, randomized, double-blind, placebo-controlled
Follow-up
12-28 hours
Authors
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Anistreplase should not be used in unstable angina; challenges angiographic surrogates as reliable predictors of clinical benefit in RCTs.
RCT (n=159)
Double-blind
randomized
Yes
Does anistreplase improve angiographic and clinical outcomes in patients with unstable angina?
Absolute Event Rate: 11% vs 3%
p-value: p=0.008
In patients with unstable angina, thrombolytic therapy with anistreplase improves angiographic stenosis but provides no clinical benefit and significantly increases bleeding complications.
Bär et al. (1992) conducted an RCT in unstable angina (n=159). anistreplase vs. placebo was evaluated on decrease in diameter stenosis between the first and second angiogram (p=0.008). Anistreplase significantly decreased diameter stenosis compared to placebo (11% vs 3%, p=0.008) in patients with unstable angina, but yielded no clinical improvement and increased bleeding.
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