Treatment of myocardial infarction with intracoronary streptokinase: efficacy and safety data from 209 United States cases in the Hoechst-Roussel registry.

Efficacy and safety data from 209 U.S. cases in the Hoechst-Roussel intracoronary streptokinase (STK) registry were analyzed. Successful recanalization was achieved in 76% of infarct-related occluded coronary arteries. Postinfarction complications (i.e., malignant arrhythmia, heart block, and pump failure) were substantially less frequent after successful recanalization compared to the recanalization failures. Cardiac in-hospital mortality was 2.5% in the recanalized group and 18% in the group in which recanalization failed. Several severe hemorrhagic complications occurred in patients who were heparinized. The data suggest that myocardial reperfusion following STK coronary recanalization during evolving myocardial infarction may salvage myocardium. Except for excessive bleeding associated generally with heparinization, side effects and adverse reactions were readily controlled.