Intravenous streptokinase significantly reduced in-hospital mortality compared to standard care in patients with acute myocardial infarction, with survival benefits persisting at 1 year.
RCT (n=11,712)
Does intravenous streptokinase added to standard care reduce mortality in patients with acute myocardial infarction?
Intravenous streptokinase significantly reduces mortality in acute myocardial infarction, with survival benefits persisting at 1 year despite an increased risk of reinfarction.
In the GISSI trial, 11,712 patients with acute myocardial infarction were randomized to receive either standard care or standard care with 1.5 million units streptokinase intravenously. A highly significant reduction in mortality during hospitalization in streptokinase-treated patients was observed. The mortality at 1 year was determined in 98.3% of the patients who had been originally randomized; the 1 year mortality of patients discharged alive was similar in those patients treated with streptokinase and those who were not; that is, the beneficial effects of streptokinase treatment on survival that were observed in the hospital phase of the study persisted unchanged and with comparable statistical significance for 1 year. However, a higher incidence of reinfarction occurred in the treated versus the control groups both during the hospital phase and at the 6 month follow-up. Streptokinase treatment had no detectable effect in patients with a history of previous infarction.
Rovelli et al. (Sun,) conducted a rct in Acute myocardial infarction (n=11,712). Streptokinase vs. Standard care was evaluated on Mortality during hospitalization. Intravenous streptokinase significantly reduced in-hospital mortality compared to standard care in patients with acute myocardial infarction, with survival benefits persisting at 1 year.