Multicenter clinical trial using an accelerated streptokinase regimen in patients with acute myocardial infarction.

OBJECTIVE: To observe the clinical efficacy and safety of intravenous thrombolytic therapy using an accelerated streptokinase (SK) regimen in acute myocardial infarction (AMI). METHODS: Data were collected from 40 hospitals during April 1996 to July 1997. Clinical therapeutic efficacy, five-week mortality, and adverse events were analyzed in 527 patients with AMI treated with an accelerated SK regimen (1.5 million IU within 30 min). RESULTS: The reperfusion rate of infarct-related arteries (IRAs) was 79.7% (421/528) assessed by clinical signs. The total mortality in the first 5 weeks was 6.6% (35/527). The incidence of allergic reactions and hypotension was 3.8% (20/528) and 4.2% (22/528), respectively. The incidence of bleeding was 2.7% (14/528), including cerebral bleeding 0.8% (4/528) and other major bleeding 0.8% (4/528). CONCLUSION: Intravenous accelerated SK therapy can markedly improve reperfusion rate without increasing adverse events such as bleeding, allergic reactions and hypotension.