PMID- 3276409
OWN - NLM
STAT- MEDLINE
DCOM- 19880314
LR  - 20190623
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 77
IP  - 2
DP  - 1988 Feb
TI  - The Western Washington Intravenous Streptokinase in Acute Myocardial Infarction 
      Randomized Trial.
PG  - 345-52
AB  - Three hundred sixty-eight patients were randomly assigned to receive intravenous 
      streptokinase (IVSK) (n = 191) or standard therapy (n = 177) to determine the 
      efficacy of IVSK in the treatment of acute myocardial infarction. The mean time 
      to treatment was 3.5 hr. At 14 days there were 12 deaths in the treatment group 
      (6.3%) and 17 deaths in the control group (9.6%) (p = .23). Early mortality was 
      related to infarct location. Fourteen day mortality for anterior infarctions was 
      10.4% for treatment with IVSK and 22.4% for control patients (p = .06) and was 
      similar for IVSK-treated patients with inferior infarctions, 4.0% vs 1.8% (p = 
      .32). For those randomized under 3 hr, 14 day mortality tends to be lower in 
      treated patients, 5.2% vs 11.5% (p = .11). There was significant improvement in 
      long-term survival for patients with anterior infarction; 2 year survival was 81% 
      for IVSK-treated patients and 65% for control patients (p = .05). There was no 
      improvement in survival for patients with inferior myocardial infarction (p = 
      .27). We conclude that patients with anterior myocardial infarction have improved 
      survival when treated within the first 6 hr of symptoms. Patients with inferior 
      infarction do not appear to have improved survival with thrombolytic therapy. 
      Some of this improvement in survival in patients with anterior infarction may be 
      due to a higher frequency of revascularization procedures in the treatment group.
FAU - Kennedy, J W
AU  - Kennedy JW
AD  - Department of Medicine, University of Washington, Seattle 98195.
FAU - Martin, G V
AU  - Martin GV
FAU - Davis, K B
AU  - Davis KB
FAU - Maynard, C
AU  - Maynard C
FAU - Stadius, M
AU  - Stadius M
FAU - Sheehan, F H
AU  - Sheehan FH
FAU - Ritchie, J L
AU  - Ritchie JL
LA  - eng
GR  - HL 30300/HL/NHLBI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - EC 3.4.- (Streptokinase)
SB  - IM
EIN - Circulation 1988 May;77(5):1037
MH  - Aged
MH  - Angiocardiography
MH  - Clinical Trials as Topic
MH  - Female
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnostic imaging/*drug therapy/mortality
MH  - Random Allocation
MH  - Streptokinase/*administration & dosage/adverse effects
MH  - Washington
EDAT- 1988/02/01 00:00
MHDA- 1988/02/01 00:01
CRDT- 1988/02/01 00:00
PHST- 1988/02/01 00:00 [pubmed]
PHST- 1988/02/01 00:01 [medline]
PHST- 1988/02/01 00:00 [entrez]
AID - 10.1161/01.cir.77.2.345 [doi]
PST - ppublish
SO  - Circulation. 1988 Feb;77(2):345-52. doi: 10.1161/01.cir.77.2.345.