[The Italian Group for the Study of Streptokinase in Myocardial Infarct: General intra-hospital results and a 1-year follow-up].

The paper summarizes the main and final results of the G.I.S.S.I. trial, with respect to the in-hospital phase and to the one year follow-up, which had as a primary end-point the assessment of cumulative and post-hospital mortality. Data on the hospital phase have been already reported and do not need any further summary. The results of the one year follow-up document that the benefit produced by SK in the hospital period remains substantially unchanged at least up to 12 months. The differences in mortality in favour of SK vs C are highly statistically significant for the whole population and specifically for the subgroups 0-3, 3-6 hrs from onset of diagnostic pain. The amplitude of the benefit shown for the subgroups treated within 1 hr is further increased during the post-hospital phase. The opposite phenomenon is documented for the subgroup with ST depression, where a disadvantage of SK treatment appears to be confirmed and strengthened at the end of the follow-up. The G.I.S.S.I. results document conclusively that an acute thrombolytic treatment with SK in AMI patients is effective in reducing mortality not only over the short, but also over the long period. This beneficial effect is specifically evident in the population treated within 6 hours from AMI occurrence; it appears particularly dramatic in the subgroup treated within 1 hr from diagnostic pain onset.