Invasive reperfusion study. II. Multicentre European randomized trial of anistreplase vs streptokinase in acute myocardial infarction.

Abstract

IRS II (Invasive reperfusion study II) was a multicentre randomized trial comparing the efficacy of a 2-5-min 30 U anistreplase intravenous injection with a 1,500,000 U 60-min streptokinase (SK) intravenous infusion in acute myocardial infarction. 116 patients were randomized within 6 h of onset of symptoms. Early coronary patency was assessable in 107 patients by coronary angiogram performed 102 min after thrombolytic treatment (range: 30-297 min) in the anistreplase group and 93 min (range: 22-330 min) in the SK group. The early coronary patency rate was significantly higher in the anistreplase group than in the SK group: respectively, 70% (38/54) and 51% (27/53), P less than 0.05). Fifty patients had assessable coronary angiograms at 90 min and 24 h. The 24-h patency rate was 92.3% (24/26) in the anistreplase group vs 87.5% (21/24) in the SK group. No early reocclusion occurred in the anistreplase group vs 15.4% (2/13) in the SK group (NS). Fibrinogen fell to 13.2 +/- 19.8% on anistreplase vs 9.4 +/- 10.3% on SK (NS). Bleeding complications occurred in 12% (7/58) of treated patients in the anistreplase group vs 20.7% (13/58) in the SK group (NS). Two cerebrovascular accidents occurred after thrombolytic treatment with anistreplase (3.4%) vs one after SK (1.7%) (NS). Thus, anistreplase is more effective than intravenous SK and easier to administer.

• Authors: G Pacouret, B Charbonnier, N D Curien, J P Monassier, A Cribier, P Materne, M L Brochier, R Letac, M Hanssen, A Sacrez
• Journal: European heart journal (Eur Heart J) Vol. 12 Issue 2 Pg. 179-85 (Feb 1991) ISSN: 0195-668X [Print] England
• PMID: 2044551 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Anistreplase
• Streptokinase

Topics

• Adult
• Aged
• Anistreplase (administration & dosage)
• Coronary Angiography
• Coronary Circulation (drug effects)
• Female
• Follow-Up Studies
• Hemodynamics (drug effects)
• Humans
• Infusion Pumps
• Injections, Intravenous
• Male
• Middle Aged
• Myocardial Infarction (mortality, therapy)
• Recurrence
• Streptokinase (administration & dosage)
• Survival Rate