Streptokinase in Acute Myocardial Infarction — Benefits and Risks
Thirty years ago in 1958 the first experience with intravenous administration of fibrinolytic agents in 22 patients with acute myocardial infarction was reported by Fletcher and coworkers in the United States . The next step was intermittent diastolic administration of fibrinolysin through a catheter in Valsalva’s sinus in 1960, reported by Boucek and Murphy . In the period between 1960 and 1966 uncontrolled and controlled studies were reported, involving intravenous administration of streptokinase with initial dose of 250×103 U followed by maintenance doses of 100×103 U/h for periods of 12–24 h in patients with acute myocardial infarction. As a result, successful treatment by thrombolysis or fibrinolysis was suspected but not proven in individual cases. Although all investigators recognized the necessity of coronary angiography, prevailing opinion at that time held that angiography in the setting of acute infarction was associated with unacceptably high risk. Randomized and controlled multicenter studies with large groups of patients were initiated to allow statistical analysis of mortality in this situation.
KeywordsAcute Myocardial Infarction Thrombolytic Therapy Thrombolytic Agent Myocardial Salvage Fibrinolytic Agent
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