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

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-Ur...

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Main Authors: Spiecker, Martin (Author) , Windeler, Jürgen (Author) , Vermeer, F. (Author) , Michels, R. (Author) , Seabra-Gomes, R. (Author) , vom Dahl, J. (Author) , Kerber, S. (Author) , Verheugt, F. W. (Author) , Westerhof, P. W. (Author) , Bär, F. W. (Author) , Nixdorff, U. (Author) , Barth, H. (Author) , Hopkins, G. R. (Author) , von Fisenne, M. J. (Author) , Meyer, J. (Author)
Format: Article (Journal)
Language:English
Published: 1999
In: American heart journal
Year: 1999, Volume: 138, Issue: 3, Pages: 518-524
ISSN:1097-6744
DOI:10.1016/s0002-8703(99)70155-9
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/s0002-8703(99)70155-9
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/abs/pii/S0002870399701559#!
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Author Notes:M. Spiecker, J. Windeler, F. Vermeer, R. Michels, R. Seabra-Gomes, J. vom Dahl, S. Kerber, F.W. Verheugt, P.W. Westerhof, F.W. Bär, U. Nixdorff, H. Barth, G.R. Hopkins, M.J. von Fisenne, J. Meyer
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Summary: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.
Item Description:Elektronische Reproduktion der Druck-Ausgabe
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Physical Description:Online Resource
ISSN:1097-6744
DOI:10.1016/s0002-8703(99)70155-9

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