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December 21, 1968BMJOpen Access

Streptokinase Therapy in Acute Major Pulmonary Embolism: Effectiveness and Problems

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Key result

Streptokinase therapy in acute major pulmonary embolism led to angiographic improvement in 75% of evaluated patients, compared to 0% in those treated with heparin.

Why the study?

Does streptokinase improve clinical and angiographic outcomes in patients with acute major pulmonary embolism?

Population

18 patients with acute major pulmonary embolism

Comparison

Streptokinase infused by a catheter or given… vs Heparin treatment (observed in 3 patients)

Design

Case_series

Follow-up

24 to 48 hours

Authors

JHJ. HirshASTERGHG. S. HaleThe University of MelbourneIMIan G. McDonaldSt. Vincent's Birmingham

Discussion

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Implication

Streptokinase may accelerate resolution in major PE; leaves open superiority over heparin pending randomized trials.

Study Design

Type

Observational (n=21)

Structured PICO

Does streptokinase improve clinical and angiographic outcomes in patients with acute major pulmonary embolism?

P
Population
21 patients with acute major pulmonary embolism (18 treated with streptokinase, 3 with heparin) evaluated for clinical and angiographic improvement.
E
Exposure
Streptokinase infused by a catheter or given intravenously for 24 to 48 hours
C
Comparator
Heparin treatment (observed in 3 patients)
O
Outcome
Clinical improvement and angiographic improvement at 24 to 48 hourssurrogate

Main Result

Absolute Event Rate: 75% vs 0%

Streptokinase therapy hastens early angiographic and clinical resolution in acute major pulmonary embolism, particularly when administered shortly after a single embolic episode.

Limitations

  • Requires adequate laboratory control

Cite This Study

Hirsh et al. (1968) conducted an observational in Acute major pulmonary embolism (n=21). Streptokinase vs. Heparin was evaluated on Angiographic improvement. Streptokinase therapy in acute major pulmonary embolism led to angiographic improvement in 75% of evaluated patients, compared to 0% in those treated with heparin.

synapsesocial.com/papers/6a6f21d235aa2c282ce08958https://doi.org/10.1136/bmj.4.5633.729

Topics

Pulmonary embolism
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