No coin nor oath required. For personal study only.
To assess potential benefits of rt-PA in addition to heparin (HEP) and aspirin (ASP) given early in acute myocardial infarction (MI), 61 pts were randomised double-blind after admission to either rt-PA 100 mgs IV over 3 hrs plus 1,000 U/hr HEP for 24 hrs plus 300 rags ASP daily (n=46) or HEP plus ASP only (n= 15). During the first 10 days, life threatening complications were less common in rt-PA pts (41% v 73%; P=0.04): rt-PA Cont rt-PA Cont Death 3(7%) 2(13%) *Sustained VT I(2%) 3(13%) Non-fatal arrest 0 4(27%) *Pulmonary congestion 9(20%) 5(33%) Hypotension/ 2(4%) 3(20%) Pacing 1(2%) 2(13%) Inotropes (*requiring medical treatment)
However, coronary arteriography at 12 days (median) showed no difference in TIMI CLASS 0-1(35% v 27%) and 2-3(65% v 73%) between rt-PA and controls. At 3 months, more rt-PA patients were angina-free with greater activity ratings (71% v 39% ; P < 0.05). In conclusion, rt-PA early in MI may reduce life threatening complications within the first week after treatment as well as early morbidity but this benefit is not associated with improved coronary patency at or soon after hospital discharge.
π SIMILAR VOLUMES