November 25, 1983

Streptokinase still lysing coronary clots

JAMA. 1983;250(20):2744-2745. doi:10.1001/jama.1983.03340200004002

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While tissue-type plasminogen activator (t-PA) is the big news in thrombolytic therapy for an evolving myocardial infarction (MI), evaluation of streptokinase for the same purpose is continuing news (JAMA 1981;245:689-694, 1982;248:805-811).

In recent weeks, discussions at meetings sponsored by the Texas Heart Institute in Houston, the American College of Chest Physicians in Chicago, and the American Heart Association in Anaheim, Calif, have addressed these questions:

  • How do results of streptokinase thrombolysis compare with results of other attempts to halt or limit an evolving MI?

  • Should streptokinase be administered via an intracoronary or peripheral intravenous (IV) route?

  • How soon should streptokinase be administered, and for how long, and what are the benefits in terms of survival and heart function?

Part of the answer to the first question may come from an ongoing prospective study supported by the National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Md. The study