In a previously reported clinical study treatment of myocardial infarction with intracoronary streptokinase (269 patients) was compared with conventional therapy (264 patients). To determine the long-term effects of thrombolytic therapy patient data were collected from 3 to 7 years after admission. Three-year survival rates were 87% after thrombolysis and 79% after conventional therapy. Bypass surgery was done in 19% versus 16%, and PTCA in 9% versus 6% of patients. Patients treated with thrombolysis also had a better prognosis after discharge. The difference in survival between the two treatment groups was 6% after 1 year and 10% after 5 years. Benefit was largest in patients with an anterior infarction, patients with extensive myocardial ischaemia and patients treated shortly after onset of infarction. Left ventricular function appeared to be the best determinant predicting survival after discharge. The findings show that early thrombolysis after acute myocardial infarction also results in improved long-term survival.

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Nederlands Tijdschrift voor Geneeskunde
Erasmus MC: University Medical Center Rotterdam