Thrombolytic therapy with intracoronary or intravenous streptokinase during acute myocardial infarction

Z Kardiol. 1985:74 Suppl 6:129-34.

Abstract

This report compares the results of intracoronary (IC) and intravenous (IV) streptokinase in a sequential series of 200 patients (IC = 81 and IV = 119) admitted within 3 hours of the onset of an acute myocardial infarction. Reperfusion was achieved in 71 of 81 (88%) patients in the IC group and in 113 of 119 (95%) patients in the IV group (p = NS) 35 +/- 27 and 42 +/- 33 minutes after commencement of treatment respectively (p = NS). The interval from onset of symptoms to reperfusion was significantly longer in the IC than in the IV group, 235 +/- 62 versus 175 +/- 61 minutes (p less than 0.001). Mean values of peak creatine kinase-MB were 152 +/- 117 IU/L in the IC group and 117 +/- 79 IU/L in the IV group (p less than 0.05). Three patients in the IC group and 16 patients in the IV group suffered major hemorrhagic complications. In-hospital mortality was 7 of 81 (8.7%) in the IC group and 10 of 119 (8.4%) in the IV group (p = NS). We conclude that IV administration of streptokinase in patients with an acute myocardial infarction is at least as efficacious as IC administration.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cerebral Hemorrhage / chemically induced
  • Coronary Vessels
  • Electrocardiography
  • Female
  • Hemorrhage / chemically induced
  • Humans
  • Infusions, Intra-Arterial
  • Infusions, Parenteral
  • Male
  • Middle Aged
  • Monitoring, Physiologic
  • Myocardial Infarction / drug therapy*
  • Streptokinase / administration & dosage*
  • Streptokinase / adverse effects

Substances

  • Streptokinase