RECANALIZATION CHARACTERISTICS OF INTRACORONARY STREPTOKINASE COMPARED TO INTRAVENOUS TISSUE-PLASMINOGEN ACTIVATOR FOLLOWING ACUTE MYOCARDIAL-INFARCTION - A COMMUNITY-HOSPITAL EXPERIENCE

This study compares the recanalization characteristics of intracoronar y streptokinase (IC-SK) with those of intravenous tissue plasminogen a ctivator (t-PA) in patients with acute myocardial infarction (AMI) tre ated in the first 6 hours after onset of symptoms. We studied 263 pati ents with AMI. Among these, 160 were treated with IC-SK; in 59 the dru g was given within the first 3 hours and in 101 from 3 to 6 hours. Ano ther 103 patients were treated with IV t-PA; in 64 the drug was given in the first 3 hours and in 39 within 3 to 6 hours. The recanalization rate in the IC-SK group at 0 to 3 hours was 73% and at 3 to 6 hours w as 71%, with an overall recanalization rate of 72% from 0 to 6 hours. In the t-PA group, the recanalization rate at 0 to 3 hours was 72% and at 3 to 6 hours was 46%, with an overall recanalization rate of 62%. We conclude that during the first 6 hours of AMI, IC-SK treatment resu lted in a rather steady thrombolysis rate, while t-PA treatment with t he standard regimen produced a significant decline in recanalization w hen administered after 3 hours from the onset of AMI symptoms.