725-4 Late Survival Following Early Coronary Intervention After Fibrinolytic Therapy with Streptokinase in Acute Myocardial Infarction (Results of a randomized trial: SIAM-I)

Autor: Markus Höhn, Klaus-Dieter Heib, Bernd Hammer, Armin Heisel, Benno Hennen, Hauke Täger, Hermann Schieffer, Wolfgang Bay, Cern Özbek, Gunther Berg
Rok vydání: 1995
Předmět:
Zdroj: Journal of the American College of Cardiology. 25:130A
ISSN: 0735-1097
DOI: 10.1016/0735-1097(95)91995-a
Popis: 324 pts with acute myocardial infarction were treated with intravenous Streptokinase (l4 hrs after onset of symptoms, 1.500.000 U/1 hr) in 13 acute care hospitals and were centrally randomized by phone call to the university hospital in two groups during fibrinolysis. Group A (invasive strategy) CA with PTCA/CABS 14 to 48 hours after start of treatment and predischarge control CA. Group B (control group) no CA within the first 21 days, unless there is evidence for ischemia and predischarge control CA. In Gr-A 14/158 (=9%) pts, in Gr-B 10/166 (=6%) pts died before hospital discharge (n.s.). In a follow-up period of at least 24 months (Median 35 months) 13/144(=9%) pts of Gr-A and 14/156 (=9%) pts of Gr-B died (n.s.). All other patients (n = 273; Gr-A: 131, Gr-B: 142) were followed for a median time of 76 months (30–89 months, 1723 patient years). In Gr-A 20/131 (= 15%) pts and in Gr-B 7/142 (=5%) pts died during this period (p l 0.008). Cumulative number of deaths in Gr-A and Gr-B Time Gr-A Gr-B p-value l14 hrs 3 (=2%) 3 (=2%) n.s. 14–48 hrs 9 (=6%) 8 (=5%) n.s. in-hospital 14 (=9%) 10 (=6%) n.s. 3-year-FU 27 (=17%) 24 (=14%) n.s. 6-year-FU 47 (=30%) 31 (=19%) l0.03 Conclusion This data exclude even a long-term superiority of an invasive approach to patients with fibrinolytic treated acute myocardial infarction. A detailed stratification to identify patients who will benefit from coronary intervention is needed.
Databáze: OpenAIRE
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