Background The relative efficacy of streptokinase and tissueplasminogen activator and the roles of intravenous as comparedwith subcutaneous heparin as adjunctive therapy in acute myocardialinfarction are unresolved questions. The current trial was designedto compare new, aggressive thrombolytic strategies with standardthrombolytic regimens in the treatment of acute myocardial infarction.Our hypothesis was that newer thrombolytic strategies that produceearlier and sustained reperfusion would improve survival.
Methods In 15 countries and 1081 hospitals, 41,021 patientswith evolving myocardial infarction were randomly assigned tofour different thrombolytic strategies, consisting of the useof streptokinase and subcutaneous heparin, streptokinase andintravenous heparin, accelerated tissue plasminogen activator(t-PA) and intravenous heparin, or a combination of streptokinaseplus t-PA with intravenous heparin. ("Accelerated" refers tothe administration of t-PA over a period of 1 1/2 hours -- withtwo thirds of the dose given in the first 30 minutes -- ratherthan the conventional period of 3 hours.) The primary end pointwas 30-day mortality.
Results The mortality rates in the four treatment groups wereas follows: streptokinase and subcutaneous heparin, 7.2 percent;streptokinase and intravenous heparin, 7.4 percent; acceleratedt-PA and intravenous heparin, 6.3 percent; and the combinationof both thrombolytic agents with intravenous heparin, 7.0 percent.This represented a 14 percent reduction (95 percent confidenceinterval, 5.9 to 21.3 percent) in mortality for acceleratedt-PA as compared with the two streptokinase-only strategies(P = 0.001). The rates of hemorrhagic stroke were 0.49 percent,0.54 percent, 0.72 percent, and 0.94 percent in the four groups,respectively, which represented a significant excess of hemorrhagicstrokes for accelerated t-PA (P = 0.03) and for the combinationstrategy (P<0.001), as compared with streptokinase only.A combined end point of death or disabling stroke was significantlylower in the accelerated-t-PA group than in the streptokinase-onlygroups (6.9 percent vs. 7.8 percent, P = 0.006).
Conclusions The findings of this large-scale trial indicatethat accelerated t-PA given with intravenous heparin providesa survival benefit over previous standard thrombolytic regimens.
Source Information
Dr. Topol, as chairman of the study, assumes full responsibility for the overall content and integrity of the manuscript.A list of the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) investigators appears in the Appendix.
Address reprint requests to Dr. Eric Topol at the Department of Cardiology, One Clinic Center, Cleveland Clinic Foundation, Cleveland, OH 44195.
Thrombolytic Therapy for Myocardial Infarction
Frei S., Brophy J., Andreotti F., Thron C. D., Topol E. J., Califf R. M., Wilcox R., The GUSTO III Steering Committee , Van de Werf F., The COBALT Investigators , Ware J. H., Antman E. M.
Extract |
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N Engl J Med 1998;
338:545-548, Feb 19, 1998.
Correspondence
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[Abstract][Full Text]
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[Abstract][Full Text]
Perlroth, D. J., Sanders, G. D., Gould, M. K.
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[Abstract][Full Text]
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297: 43-51
[Abstract][Full Text]
Weisfeldt, M. L., Zieman, S. J.
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26: 25-37
[Abstract][Full Text]
Bhala, N., Hamon, M., Riddell, J. W., Karthikeyan, G., Pasceri, V., Schuler, J., Altenberger, J., Heigert, M., Montalescot, G., White, H. D., Steinhubl, S. R.
(2006). Enoxaparin in elective percutaneous coronary intervention.. NEJM
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114: 2871-2891
[Full Text]
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[Abstract][Full Text]
Yusuf, S., Mehta, S. R.
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[Full Text]
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[Abstract][Full Text]
Sabatine, M. S.
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[Abstract][Full Text]
Eikelboom, J. W., Hirsh, J.
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[Abstract][Full Text]
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[Abstract][Full Text]
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[Abstract][Full Text]
Schomig, A., Ndrepepa, G., Kastrati, A.
(2006). Late myocardial salvage: time to recognize its reality in the reperfusion therapy of acute myocardial infarction. Eur Heart J
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[Abstract][Full Text]
Adesanya, A. O., de Lemos, J. A., Greilich, N. B., Whitten, C. W.
(2006). Management of perioperative myocardial infarction in noncardiac surgical patients.. Chest
130: 584-596
[Abstract][Full Text]
De Cristofaro, R
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92: 1011-1012
[Full Text]
Rabinstein, A. A., Rozenman, Y., Kongsaengdao, S., Arayawichanont, A., Almanaseer, Y., Desai, D. M., Kamalesh, M., Topol, E. J., the CHARISMA Investigators,
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355: 418-419
[Full Text]
Kaul, S., Diamond, G. A.
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145: 62-69
[Abstract][Full Text]
Mahmoud, T H, Peng, Y-W, Proia, A D, Davidson, M, Deramo, V A, Fekrat, S
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[Abstract][Full Text]
Goyal, A., Mahaffey, K. W., Garg, J., Nicolau, J. C., Hochman, J. S., Weaver, W. D., Theroux, P., Oliveira, G. B.F., Todaro, T. G., Mojcik, C. F., Armstrong, P. W., Granger, C. B.
(2006). Prognostic significance of the change in glucose level in the first 24 h after acute myocardial infarction: results from the CARDINAL study. Eur Heart J
27: 1289-1297
[Abstract][Full Text]
Gray, D
(2006). Thrombolysis: past, present, and future.. Postgrad. Med. J.
82: 372-375
[Abstract][Full Text]
Johnston, S, Brightwell, R, Ziman, M
(2006). Paramedics and pre-hospital management of acute myocardial infarction: diagnosis and reperfusion. Emerg. Med. J.
23: 331-334
[Abstract][Full Text]
Bhatt, D. L., Fox, K. A.A., Hacke, W., Berger, P. B., Black, H. R., Boden, W. E., Cacoub, P., Cohen, E. A., Creager, M. A., Easton, J. D., Flather, M. D., Haffner, S. M., Hamm, C. W., Hankey, G. J., Johnston, S. C., Mak, K.-H., Mas, J.-L., Montalescot, G., Pearson, T. A., Steg, P. G., Steinhubl, S. R., Weber, M. A., Brennan, D. M., Fabry-Ribaudo, L., Booth, J., Topol, E. J., the CHARISMA Investigators,
(2006). Clopidogrel and Aspirin versus Aspirin Alone for the Prevention of Atherothrombotic Events. NEJM
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[Abstract][Full Text]
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(2006). Enoxaparin versus Unfractionated Heparin with Fibrinolysis for ST-Elevation Myocardial Infarction. NEJM
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[Abstract][Full Text]
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[Abstract][Full Text]
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(2006). A Comparison of the Clinical Impact of Bleeding Measured by Two Different Classifications Among Patients With Acute Coronary Syndromes. J Am Coll Cardiol
47: 809-816
[Abstract][Full Text]
Mrdovic, I. B.
(2006). Is the level of evidence for the use of beta-blockers in acute myocardial infarction satisfactory enough?. Eur Heart J
27: 118-119
[Full Text]
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112: IV-89-IV-110
[Full Text]
Liew, Y. P., Bartholomew, J. R
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[Abstract]
Coons, J. C, Seybert, A. L, Saul, M. I, Kirisci, L., Kane-Gill, S. L
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Duvernoy, C. S., Bates, E. R.
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[Abstract][Full Text]
Schofield, P M
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Hermentin, P., Cuesta-Linker, T., Weisse, J., Schmidt, K.-H., Knorst, M., Scheld, M., Thimme, M.
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Piscione, F, Galasso, G, De Luca, G, Marrazzo, G, Sarno, G, Viola, O, Accardo, D, Chiariello, M
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De Luca, G., Suryapranata, H., Stone, G. W., Antoniucci, D., Tcheng, J. E., Neumann, F.-J., Van de Werf, F., Antman, E. M., Topol, E. J.
(2005). Abciximab as Adjunctive Therapy to Reperfusion in Acute ST-Segment Elevation Myocardial Infarction: A Meta-analysis of Randomized Trials. JAMA
293: 1759-1765
[Abstract][Full Text]
Zakarija, A., Bennett, C. L.
(2005). Low-Molecular-Weight Heparins: Do We Have the GUSTO to Identify Differences Between Alternative Formulations?. Arch Intern Med
165: 722-723
[Full Text]
Bellenger, N G, Yousef, Z, Rajappan, K, Marber, M S, Pennell, D J
(2005). Infarct zone viability influences ventricular remodelling after late recanalisation of an occluded infarct related artery. Heart
91: 478-483
[Abstract][Full Text]
Sabatine, M. S., Cannon, C. P., Gibson, C. M., Lopez-Sendon, J. L., Montalescot, G., Theroux, P., Claeys, M. J., Cools, F., Hill, K. A., Skene, A. M., McCabe, C. H., Braunwald, E., the CLARITY-TIMI 28 Investigators,
(2005). Addition of Clopidogrel to Aspirin and Fibrinolytic Therapy for Myocardial Infarction with ST-Segment Elevation. NEJM
352: 1179-1189
[Abstract][Full Text]
Brophy, J. M., Joseph, L.
(2005). Medical Decision Making with Incomplete Evidence--Choosing a Platelet Glycoprotein IIbIIIa Receptor Inhibitor for Percutaneous Coronary Interventions. Med Decis Making
25: 222-228
[Abstract]
Sutton, A G C, Finn, P, Hall, J A, Harcombe, A A, Wright, R A, de Belder, M A
(2005). Predictors of outcome after percutaneous treatment for cardiogenic shock. Heart
91: 339-344
[Abstract][Full Text]
Kalus, J. S, Moser, L. R
(2005). Evolving Role of Low-Molecular-Weight Heparins in ST-Elevation Myocardial Infarction. The Annals of Pharmacotherapy
39: 481-491
[Abstract][Full Text]
Mehta, R. H., Granger, C. B., Alexander, K. P., Bossone, E., White, H. D., Sketch, M. H. Jr
(2005). Reperfusion strategies for acute myocardial infarction in the elderly: Benefits and risks. J Am Coll Cardiol
45: 471-478
[Abstract][Full Text]
The CREATE Trial Group Investigators*,
(2005). Effects of Reviparin, a Low-Molecular-Weight Heparin, on Mortality, Reinfarction, and Strokes in Patients With Acute Myocardial Infarction Presenting With ST-Segment Elevation. JAMA
293: 427-435
[Abstract][Full Text]
Hirsh, J., O'Donnell, M., Weitz, J. I.
(2005). New anticoagulants. Blood
105: 453-463
[Abstract][Full Text]
Krucoff, M. W., Johanson, P., Baeza, R., Crater, S. W., Dellborg, M.
(2004). Clinical Utility of Serial and Continuous ST-Segment Recovery Assessment in Patients With Acute ST-Elevation Myocardial Infarction: Assessing the Dynamics of Epicardial and Myocardial Reperfusion. Circulation
110: e533-e539
[Full Text]
Furber, A. P., Prunier, F., Nguyen, H. C. P., Boulet, S., Delepine, S., Geslin, P.
(2004). Coronary Blood Flow Assessment After Successful Angioplasty for Acute Myocardial Infarction Predicts the Risk of Long-Term Cardiac Events. Circulation
110: 3527-3533
[Abstract][Full Text]
Moser, L. R, Kalus, J. S
(2004). Role of Low-Molecular-Weight Heparin in Invasive Management of Non-ST-Elevation Acute Coronary Syndromes. The Annals of Pharmacotherapy
38: 2094-2104
[Abstract][Full Text]
Velazquez, E. J., Francis, G. S., Armstrong, P. W., Aylward, P. E., Diaz, R., O'Connor, C. M., White, H. D., Henis, M., Rittenhouse, L. M., Kilaru, R., Gilst, W. v., Ertl, G., Maggioni, A. P., Spac, J., Weaver, W. D., Rouleau, J.-L., McMurray, J. J.V., Pfeffer, M. A., Califf, R. M.
(2004). An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry. Eur Heart J
25: 1911-1919
[Abstract][Full Text]
Corfield, A R, Graham, C A, Adams, J N, Booth, I, McGuffie, A C
(2004). Emergency department thrombolysis improves door to needle times. Emerg. Med. J.
21: 676-680
[Abstract][Full Text]
Rao, S. V., Jollis, J. G., Harrington, R. A., Granger, C. B., Newby, L. K., Armstrong, P. W., Moliterno, D. J., Lindblad, L., Pieper, K., Topol, E. J., Stamler, J. S., Califf, R. M.
(2004). Relationship of Blood Transfusion and Clinical Outcomes in Patients With Acute Coronary Syndromes. JAMA
292: 1555-1562
[Abstract][Full Text]
Bradley, E. H., Herrin, J., Wang, Y., McNamara, R. L., Webster, T. R., Magid, D. J., Blaney, M., Peterson, E. D., Canto, J. G., Pollack,, C. V. Jr, Krumholz, H. M.
(2004). Racial and Ethnic Differences in Time to Acute Reperfusion Therapy for Patients Hospitalized With Myocardial Infarction. JAMA
292: 1563-1572
[Abstract][Full Text]
Kaul, P., Armstrong, P. W., Chang, W.-C., Naylor, C. D., Granger, C. B., Lee, K. L., Peterson, E. D., Califf, R. M., Topol, E. J., Mark, D. B.
(2004). Long-Term Mortality of Patients With Acute Myocardial Infarction in the United States and Canada: Comparison of Patients Enrolled in Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-I. Circulation
110: 1754-1760
[Abstract][Full Text]
Weitz, J. I., Hirsh, J., Samama, M. M.
(2004). New Anticoagulant Drugs: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 265S-286S
[Abstract][Full Text]
Albers, G. W., Amarenco, P., Easton, J. D., Sacco, R. L., Teal, P.
(2004). Antithrombotic and Thrombolytic Therapy for Ischemic Stroke: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 483S-512S
[Abstract][Full Text]
Menon, V., Harrington, R. A., Hochman, J. S., Cannon, C. P., Goodman, S. D., Wilcox, R. G., Schunemann, H. J., Ohman, E. M.
(2004). Thrombolysis and Adjunctive Therapy in Acute Myocardial Infarction: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 549S-575S
[Abstract][Full Text]
Brophy, J. M., Bogaty, P.
(2004). Primary Angioplasty and Thrombolysis Are Both Reasonable Options in Acute Myocardial Infarction. ANN INTERN MED
141: 292-297
[Abstract][Full Text]
Sato, H., Iida, H., Tanaka, A., Tanaka, H., Shimodouzono, S., Uchida, E., Kawarabayashi, T., Yoshikawa, J.
(2004). The decrease of plaque volume during percutaneous coronary intervention has a negative impact on coronary flow in acute myocardial infarction: A major role of percutaneous coronary intervention-induced embolization. J Am Coll Cardiol
44: 300-304
[Abstract][Full Text]
Sazonova, I. Y., Robinson, B. R., Gladysheva, I. P., Castellino, F. J., Reed, G. L.
(2004). {alpha} Domain Deletion Converts Streptokinase into a Fibrin-dependent Plasminogen Activator through Mechanisms Akin to Staphylokinase and Tissue Plasminogen Activator. J. Biol. Chem.
279: 24994-25001
[Abstract][Full Text]
Diamond, G. A., Kaul, S.
(2004). Prior convictions: bayesian approaches to the analysis and interpretation of clinical megatrials. J Am Coll Cardiol
43: 1929-1939
[Abstract][Full Text]
A correction has been published: N Engl J Med 1994;331(4):277.
