G Ital Cardiol. 1987 Jan;17(1):20-9.
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.
本文总结了GISSI试验在住院阶段和一年随访期的主要及最终结果，其主要终点是评估累积死亡率和出院后死亡率。关于住院阶段的数据已报告，无需进一步总结。一年随访结果表明，链激酶（SK）在住院期间产生的益处至少在12个月内基本保持不变。在整个人群中，尤其是在诊断性疼痛发作后0至3小时、3至6小时的亚组中，SK组与对照组（C）相比，死亡率差异具有高度统计学意义。在1小时内接受治疗的亚组，其在出院后阶段所显示的益处幅度进一步增加。对于ST段压低亚组，情况则相反，在随访结束时，SK治疗的劣势似乎得到证实且有所加剧。GISSI结果确凿地证明，急性心肌梗死（AMI）患者采用SK进行溶栓治疗不仅在短期内，而且在长期内都能有效降低死亡率。这种有益效果在AMI发生后6小时内接受治疗的人群中尤为明显；在诊断性疼痛发作后1小时内接受治疗的亚组中，效果尤为显著。
