A comparative study of intravenous accelerated streptokinase dose regimen with conventional dose regimen for coronary thrombolysis.

The aim of this study is to test the patency rate and safety of the accelerated streptokinase dose regimen for coronary thrombolysis compared with the conventional one. One hundred and four patients entering three hospitals up to 12 hours after the onset of definite acute myocardial infarction were randomizely treated with intravenous accelerated streptokinase dose regimen (1.5 million units/30 min) (group A, 47 cases) and conventional dose regimen (1.5 million units/60 min) (group B, 57 casese). The reperfusion rate of infarct-related arteries determined by clinical evidence of reperfusion was 76.6% (36/47) in group A VS 61.4% (35/57) in group B. There was significant difference in reperfusion rates among patients within 6 hours after the onset of chest pain: 87.9% (29/33) in group A VS 67.4 (29/43) in group B (P < 0.05). The incidence of mild bleeding, allergic reaction, hypotension was 12.8% (6/47), 4.3% (2/47), 12.8 (6/47) respectively in group A vs 21.1 (12/57), 3.5 (2/57), 17.5% (10/57) respectively in group B. Compared to conventional dose regimen, intravenous accelerated streptokinase dose regimen for coronary thrombolysis seems to improve reperfusion rate markedly without increasing adverse events such as bleeding, allergic reaction and hypotension. It suggests that accelerated streptokinase therapy deserves more extensive investigation.