Long-term outcome was evaluated over a 1-year follow-up period in 401 patients who had suffered a first acute myocardial infarction
Patients were treated within 4 hours of onset of symptoms with either 80 mg saruplase (n - 198) or 1.5 million IU streptokinase (n-203) infused over 60 minutes.
Mortality was low: 5.9% overall, 6.3% in the saruplase-treated patients, and 5.6% in the streptokinase-treated patients (P-0.83). Reinfarction rate after discharge was 2.7% versus 2.2% and recurrent angina pectoris occurred in 22.0% versus 25.6%, respectively, in the saruplase and streptokinase groups. The majority of patients had no symptoms of left ventricular failure (New York Heart Association [NYHAJ class I: 73.3% and 72.5%); no patient's condition was classified as NYHA class IV. Percutaneous transluminal coronary angioplasty (PTCA) was required during the hospital stay in 42.4% (saruplase group) versus 46.3% (streptokinase group). Late PTCA (up to 1 year) was necessary in 10.2% (saruplase group) versus 5.8% (streptokinase group). A bypass graft was performed in 12.6% (saruplase) versus 11.3% (streptokinase) early and in 8.3% (saruplase) versus 6.7% (streptokinase) late after thrombolytic therapy.
Early patency rate was greater and adverse events less common with saruplase than streptokinase. However, functional status was similar and mortality was low in both treatment groups up to 1 year after start of treatment.
© Lippincott-Raven Publishers.