Invasive reperfusion study II. Multicentre European randomized trial of anistreplase vs streptokinase in acute myocardial infarction |
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Authors: | PACOURET G; CHARBONNIER B; CURIEN N D; MONASSIER JP; CRIBIER A; MATERNE P; BROCHIER MIREILLE L; LETAC R; HANSSEN M; SACREZ A; KULBERTUS H |
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Institution: | *Cardiology Department, University Hospital Trousseau Tours, France
Hópital Bichat Paris, France
||Clinique St Joseph Colmar, France
¶Cardiology Department, University Hospital Rouen, France
Cardiology Department, Hôpital de Baviére Liège, Belgium
Cardiology Department, University Hospital Strasbourg, France |
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Abstract: | IRS II (Invasive reperfusion study II) was a multicentre randomizedtrial comparing the efficacy of a 25-min 30 U anistreplaseintravenous injection with a 1 500 000 U 60-min streptokinase(SK) intravenous infusion in acute myocardial infarction. 116patients were randomized within 6 h of onset of symptoms. Earlycoronary patency was assessable in 107 patients by coronaryangiogram performed 102 min after thrombolytic treatment (range:30297 min) in the anistreplase group and 93 min (range:22330 min) in the SK group. The early coronary patencyrate was significantly higher in the anistreplase group thanin the SK group: respectively, 70% (38/54) and 51% (27/53),P<0.05. Fifty patients had assessable coronary angiogramsat 90 min and 24 h. The 24-h patency rate was 92.3% (24/26)in the anistreplase group vs 87.5% (21/24) in the SK group.No early reocclusion occurred in the anistreplase group vs 15.4%(2/13) in the SK group (NS). Fibrinogen fell to 13.2 ±19.8%on anistreplase vs 9.4 ±10.3% on SK (NS). Bleeding complicationsoccurred in 12% (7/58) of treated patients in the anistreplasegroup vs 20.7% (13/58) in the SK group (NS). Two cerebrovascularaccidents occurred after thrombolytic treatment with anistreplase(3.4%) vs one after SK (1.7%) (NS). Thus, anistreplase is moreeffective than intravenous SK and easier to administer. |
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Keywords: | Acute myocardial infarction thrombolysis streptokinase early coronary patency rate reocclusion anistreplase |
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