Why the study?
Do different thrombolytic agents differ in reducing 30-35 day mortality and major adverse effects in patients with acute myocardial infarction?
Population
142,907 patients in the early stages of acute myocardial infarction from 14 randomized controlled trials
Comparison
Thrombolytic agents vs Alternative thrombolytic agents
Design
Meta-analysis
Follow-up
30-35 days
Key result
Thrombolytic agents showed no significant differences in 30-35 day mortality, but total stroke rates were lower for streptokinase than for all alteplase combined (OR 1.29; 95% CI 1.13-1.46).
Authors
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Equivalent mortality reduction across thrombolytics in AMI; challenges GUSTO-I alteplase superiority while confirming streptokinase's lower stroke risk.
Systematic Review (n=142,907)
Do different thrombolytic agents differ in reducing 30-35 day mortality and major adverse effects in patients with acute myocardial infarction?
All evaluated thrombolytic drugs appear to have similar efficacy in reducing 30-35 day mortality in acute myocardial infarction, though streptokinase is associated with lower stroke rates compared to alteplase.
Y Dündar (2003) conducted a systematic review in acute myocardial infarction (n=142,907). Thrombolytic agents (reteplase, tenecteplase, alteplase) vs. Streptokinase was evaluated on 30-35 day mortality. Thrombolytic agents showed no significant differences in 30-35 day mortality, but total stroke rates were lower for streptokinase than for all alteplase combined (OR 1.29; 95% CI 1.13-1.46).
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