Comparison of mortality from acute myocardial infarction in patients receiving anistreplase with those not receiving thrombolysis

Am J Cardiol. 1995 Dec 1;76(16):1103-7. doi: 10.1016/s0002-9149(99)80314-2.


Within 1 year, 434 patients were admitted to 14 hospitals with suspected acute myocardial infarction (AMI) < or = 4 hours after the onset of symptoms. Group A consisted of 171 patients (39%) treated with thrombolysis, and group B consisted of 263 patients (61%) with contraindications. Patients in group A more likely had a "definite AMI" (92%; group A1) than patients in group B (67%; group B1). Group B1 had 277 contraindications (1.6/per patient) with increased risk for life-threatening bleeding being the most frequently recorded at admission. The in-hospital mortality in group A1 was 7% (11 of 158) and in group B1, 27% (47 of 177) (p < 0.0001). Age and type of therapy (thrombolysis or no thrombolysis) were identified as independent predictors of increased mortality (p < 0.0001 and < 0.05, respectively). Thus, although most patients with an AMI are excluded from thrombolytic therapy because of contraindications, our data suggest that their in-hospital mortality is unexpectedly high. Further evaluation of this group of patients is warranted to define the impact of contraindications as an independent factor of mortality.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anistreplase / therapeutic use*
  • Contraindications
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Hospital Mortality
  • Humans
  • Male
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / mortality*
  • Prospective Studies
  • Thrombolytic Therapy*


  • Fibrinolytic Agents
  • Anistreplase