The international registry to support approval of intracoronary streptokinase thrombolysis in the treatment of myocardial infarction. Assessment of safety and efficacy.

The data from 224 cases of acute myocardial infarction treated with intracoronary streptokinase plus standard coronary care unit management and 178 cases of acute myocardial infarction treated solely with standard coronary care unit management were reviewed to assess the efficacy and safety of the intracoronary administration of streptokinase during evolving myocardial infarction. Successful recanalization of the occluded infarct-related coronary artery was achieved in 176 of 224 streptokinase-treated cases (79%). The incidence of in-hospital postinfarction complications was lower and the mean left ventricular ejection fraction was improved in the successfully reperfused group. The in-hospital cardiac mortality in the reperfused patients was 4.5%. The intervention with coronary angiography and intracoronary streptokinase was generally well tolerated. Adverse reactions were relatively infrequent and were controlled with standard treatment.