Fibrinolytic Treatment in Acute Myocardial Infarction

Abstract. A total of 426 patients admitted with symptoms of acute myocardial infarction have been treated in four hospitals. 219 were treated with streptokinase (SK), 600 000 IU or more, while 207 formed the control group. The patients were followed up as long as they stayed in the hospital, which was approximately three weeks, and by one visit to the outpatient clinic six weeks after their admission to hospital. The total mortality in the SK group during six weeks was 22 and in the control group 17 patients. If only the patients with their first episode of myocardial infarction are considered, 14 of the 156 (9.0%) in the SK group and 15 of the 163 (9.2%) in the control group died. Eight of the 40 patients with a recurrent infarction in the SK group and two of the 24 in the control group died. No differences in the ECG changes were noted between the groups. The serum GOT values in the first 24 h following the infarction were higher in the SK group than in the control group in patients whose infusion had been started within the first 6 hours after the onset of chest pain. In cases with a longer history no difference was observed. The BSR of the SK group fell immediately after the infusion and remained below the values of the control group for the first two weeks. The present study did not support the view that SK would be beneficial in the treatment of myocardial infarction.