[The Italian Group for the Study of Streptokinase in Myocardial Infarct: Analysis of intrahospital causes of death].

Aim of the present study was to analyse the causes of death of the patients admitted to the G.I.S.S.I. Study. Clinical records of the 1386 in-hospital deaths were centrally analysed by two independent clinicians, who were not aware of the performed treatment and based their classification criteria upon clinical and anatomic data. Death causes were classified as follows: cardiac failure, electromechanical dissociation, cardiac rupture, sudden death and extracardiac deaths. Cardiac failure was the most frequent cause of mortality, as 725 pts out of the 1386 (52%) died from this complication in the whole group. 392 pts were part of the control group (6.7%), while 333 had received SK (5.6%): the difference was significant. No difference was observed between treated patients and control group for what concerns the remaining causes of death. Mortality from cardiac failure was strikingly reduced in a few groups of patients: females (from 11.4 down to 8.7%); age less than 65 years (from 4.1 down to 3.2%); early treated pts (up to 3 hrs): from 6.3 down to 5.2%; anterior location of AMI (9.2 down to 7.4%); first AMI episode (from 5.9 down to 4.7%). Such a reduction was remarkable for patients who remained alive after the 7th day from onset of symptoms: cardiac failure was the cause of death in 65 out of 5385 treated patients, and in 100 out of 5333 control group patients.(ABSTRACT TRUNCATED AT 250 WORDS)