Comparison of results of intravenous infusion of anistreplase versus streptokinase in acute myocardial infarction

Vogt, Pierre; Monnier, P; Schaller, M. D.; Goy, J.‐J.; Beuret, Philippe; Essinger, A; Bachmann, Fédor; Hauert, J; Perret, C; Sigwart, Ulrich; Kappenberger, Lukas

doi:10.1016/0002-9149(93)90790-j

Cited by 6 publications

(1 citation statement)

References 26 publications

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“…Of 8046 articles, 3206 were duplicates and removed, 4440 were excluded after viewing the title and abstract, and 340 were further excluded after full‐text review. Finally, a total of 58 RCTs 9,11–17,21–70 with 111 eligible study arms containing 16 536 patients with STEMI in 60 articles were included in the analysis. Of these 58 trials, 81% of the patients were male, 17 trials had only 1 arm eligible and 41 trials had 2 or more arms eligible (Table 1).…”

Section: Resultsmentioning

confidence: 99%

The recanalization after thrombolysis as surrogate for clinical outcomes in patients with ST‐segment elevation acute myocardial infarction: A systematic review and meta‐regression analysis of data from randomized controlled trials

Zhu

Chen

Zhao

et al. 2021

Brit J Clinical Pharma

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Thrombolytic therapy has been known to be effective in reducing clinical outcomes and increasing recanalization rate among patients with ST-segment elevation acute myocardial infarction (STEMI). However, whether post-thrombolysis recanalization could be used as a surrogate for clinical outcomes is unknown.Methods: We systematically searched PubMed, EMBASE and the Cochrane Library database to identify randomized controlled trials (RCT) that examined effects of thrombolytic agents in STEMI. Recanalization was defined as TIMI grade 2 or 3 flow.The primary outcome was in-hospital all-cause mortality. Secondary outcomes included in-hospital and 30-day recurrent myocardial infarction (re-MI), composite of death and re-MI, major bleeding and all bleeding. Random-effects meta-regression was used for analysis. Results:We identified 111 eligible study arms and 52 eligible comparisons from 58 RCTs involving 16 536 patients. Our analyses showed that among study arms recanalization rate was significantly inversely associated with the incidence of inhospital all-cause mortality (β: À0.07, 95% confidence interval [CI]: À0.13 to À0.02), re-MI (β: À0.09, 95%CI: À0.18 to À0.01) and the composite of death and re-MI (β: À0.17, 95%CI: À0.28 to À0.05), and positively associated with in-hospital all bleeding but not with major bleeding. Among paired comparisons, the difference in recanalization rate was associated with the corresponding difference in incidence of in-hospital all-cause mortality (β: À0.15, 95%CI: À0.28 to À0.01) but the relationship was not significant for any other outcome. Conclusion:Pooled evidence from RCTs suggest the potential use of recanalization as a surrogate for clinical outcomes in evaluating the efficacy of thrombolysis among patients with STEMI.

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Section: Resultsmentioning

confidence: 99%