The Urokinase-Streptokinase Pulmonary Embolism Trial (Phase II) Results

Abstract

No reduction in human mortality was seen with the use of thrombolytic agents. A trial designed with mortality as the main end point would require a prohibitively large patient sample. A major physiologic benefit, especially in patients with massive embolism, was observed. These agents have potential, in the severely ill patients with massive embolism and in patients with massive or submassive embolism who also have diminished cardiac reserve. When standard anticoagulation has been chosen as the initial treatment in a patient with pulmonary embolism, thrombolytic therapy should be considered if the clinical response is unsatisfactory. Both urokinase and streptokinase have promise as useful alternatives to heparin and oral anticoagulants and the hazardous proceure of embolectomy.