The purpose of this study was to analyse the effects of thrombolytic therapy
with intracoronary streptokinase in patients with acute myocardial infarction.
Five centres participated in the study, the Thorax center in Rotterdam (237
patients), the Academic Hospital of the Free University of Amsterdam (93
patients), the Zuiderziekenhuis in Rotterdam (61 patients), the Academic
Hospital of the University of Limburg in Maastricht (123 patients) and the
Academic Hospital of Leiden (19 patients). The study was conducted by the
Interuniversity Cardiology Institute the Netherlands. A strategy aimed at
early reperfusion, including acute coronary angiography and intracoronary
administration of streptokinase, was compared to conventional therapy of
myocardial infarction without acute angiography and without administration
of fibrinolytic therapy. Patients were eligible for the study if admitted to the
hospital within four hours after onset of symptoms and with electrocardiographic
signs typical for acute myocardial infarction. Patients over 70 years
of age and patients with enhanced risks of bleeding were excluded. A total of 533 patients were included in the study of which 264 were
randomly allocated to conventional treatment and 269 to thrombolytic
therapy. Informed consent was sought from patients allocated to thrombolytic
therapy only. Final patency of the infarct related artery was achieved with
intracoronary streptokinase (usually 250,000 U) in 198 out of 234 patients
(85% ). In 98 patients angiography was preceded by intravenous infusion of
strep
