Thrombolysis with saruplase versus streptokinase in acute myocardial infarction: Five-year results of the PRIMI Trial

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• 作者：Martin Spiecker ; Jü ; rgen Windeler ; Frank Vermeer ; Rolf Michels ; Ricardo Seabra-Gomes ; Jü ; rgen vom Dahl ; Sebastian Kerber ; Freek W.A. Verheugt ; Pieter W. Westerhof ; Frits W. Bä ; r ; Uwe Nixdorff ; Hannes Barth ; Gwyn R. Hopkins ; Michael J.M. von Fisenne ; Jü ; rgen Meyer ; For the PRIMI Inve
• 刊名：American Heart Journal
• 出版年：1999
• 出版时间：September 1999
• 年：1999
• 卷：138
• 期：3
• 页码：518-524
• 全文大小：174 K

文摘

Background Short-term safety and efficacy of thrombolysis with saruplase in acute myocardial infarction have been shown in several trials. To assess long-term outcome of patients treated with saruplase or streptokinase for myocardial infarction, a 5-year follow-up of patients included in the Pro-Urokinase in Myocardial Infarction Trial was performed. Methods and Results Follow-up data are available from 8 centers on 255 (92.4 % ) of 276 included patients. The 5-year mortality rate was comparable with 20.8 % of patients in the saruplase group and 16.9 % in the streptokinase group (odds ratio 1.29, 95 % confidence interval 0.69 to 2.42). In both groups, a considerable number of fatal cardiovascular events occurred more than 1 year after study inclusion. Rates of percutaneous transluminal coronary angioplasty and coronary artery bypass grafting were comparable in both groups. Reinfarction within 5 years occurred in 19.0 % of patients in the saruplase group and tended to be less frequent at 10.8 % after streptokinase treatment (odds ratio 1.94, 95 % confidence interval 0.98 to 3.84). In both groups, the majority of reinfarctions took place more than 3 months after study inclusion. The 5-year stroke rate was 3.6 % and 7.2 % in the saruplase and streptokinase groups, respectively (odds ratio 0.49, 95 % confidence interval 0.16 to 1.47). Subjective symptoms of heart failure and angina pectoris were comparable in both groups. Conclusions Our data are consistent with a similar long-term outcome for patients treated with saruplase or streptokinase. Despite the low-risk profile of the patient cohort, there were considerable adverse event rates over a 5-year period. (Am Heart J 1999;138:518-24.)