Intracoronary and Intravenous Streptokinase in Acute Myocardial Infarction: A Comparative Report

Abstract

This report compares the results of intracoronary (IC) and intravenous (IV) streptokinase in two sequential series of 81 and 95 patients, respectively, admitted within 3 h of the onset of an acute myocardial infarction. Reperfusion was achieved in 71 of 81 (87·7%) patients in the IC group and in 90 of 95 (94·7%) patients in the IV group (P = NS), 35 ± 27 and 38 ± 28 min after commencement of treatment, respectively (P = NS). The interval from onset of symptoms to reperfusion was significantly longer in the IC than in the IV group, 235 ± 62 versus 169 ± 53 minutes (P−1 in the IC group and 119 ± 81 IU l⁻¹ in the IV group (P<0·05). There were 3 serious haemorrhagic complications in the IC group and 10 in the IV group. In-hospital mortality was 7 of 81 (8·7%) in the IC group and 7 of 95 (7·4%) in the IV group (P = NS). We conclude that intravenous administration of streptokinase is at least as efficacious as intracoronary administration in patients with an acute myocardial infarction.