Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Oct 1989
Review Multicenter Study Clinical Trial[Effects of thrombolytic treatments on the mortality of myocardial infarction. Characteristics of large-scale trials, main results].
The characteristic features and principal results of the 5 large-scale randomised therapeutic trials (GISSI, ISIS 2, ASSET, AIMS, ISAM), each including over 1000 patients, designed to evaluate the effects of thrombolysis on mortality in myocardial infarction, are reviewed. The methodologies are very different, which prevents comparison of results. The thrombolytic therapy significantly reduced hospital mortality in all the trials except ISAM. ⋯ The tolerance was satisfactory, the frequency of complications being comparable in all the trials. The association of aspirin therapy significantly reduced mortality and occurrence of myocardial infarction in the ISIS 2 trial and would seem to be therefore a recommended association with streptokinase and probably with other thrombolytic drugs. Other trials are needed to compare the efficacy of the different thrombolytic agents in reducing patient mortality.