[Thrombolysis in acute myocardial infarction. Streptokinase or r-TPA?].

PURPOSE: To compare the results of intravenous thrombolytic therapy with streptokinase (SK), with those of the recombinant human tissue-type plasminogen activator (r-TPA), in acute myocardial infarction (AMI). MATERIAL AND METHODS: One hundred patients with AMI of less than 6 hours duration were randomized in two groups: 50 patients were allocated to 1.200.000 IU of SK (Group SK) and 50 patients received 100 mg of r-TPA over 180 minutes. The two groups were similar respecting age, sex, location and previous infarction. The angiographic study was performed 48 h after the thrombolytic therapy. RESULTS: In the angiographic study, 85% of the Group SK vs 66% of Group r-TPA had patient infarct-related vessel (p = 0.025). Reocclusion was 6.6% in Group SK vs 19% in Group r-TPA and hospital mortality was similar in the two groups. CONCLUSION: In the late angiographic evaluation (48 h), the frequency of coronary patency was found to be higher after intravenous SK than after intravenous r-TPA.