Why the study?
Does accelerated t-PA with intravenous heparin reduce 30-day mortality compared to streptokinase regimens in patients with evolving acute myocardial infarction?
Population
41,021 patients with evolving acute myocardial infarction across 15 countries and 1081 hospitals.
Comparison
Accelerated tissue plasminogen activator with… vs Streptokinase with subcutaneous heparin, or…
Design
RCT, Randomly assigned to four different thrombolytic strategies
Follow-up
30 days
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Accelerated t-PA with heparin should replace streptokinase as preferred reperfusion in AMI; confirms mortality benefit in this RCT.
Does accelerated t-PA with intravenous heparin reduce 30-day mortality compared to streptokinase regimens in patients with evolving acute myocardial infarction?
Accelerated t-PA with intravenous heparin provides a significant survival benefit over standard streptokinase regimens in acute myocardial infarction, despite a small increase in hemorrhagic stroke.
A 1993 study studied this question.