[Left ventricular function in the acute phase of patients with myocardial infarction randomly treated with 750,000 or 1.5 million units of streptokinase].

PURPOSE

To compare the doses of 750,000 and 1.5 million units (U) of streptokinase (SK), relatively to the left ventricular (LV) systolic function analyzed through contrasted ventriculography.

METHODS

We included 110 patients with acute myocardial infarction (AMI) within 6h of the onset (mean-age 60 years, 83.6% men), that were randomized to receive 750,000U of SK in 15 min (55 patients), or 1.5 million U in 30 min (55 patients). The study main goal was the comparison between the groups relatively to LV ejection fraction, global and regional shortening, obtained at the fifth day of the AMI.

RESULTS

The 750,000 and 1.5 million groups were homogeneous relatively to 15 analyzed variables. Relatively to the main goal of the study, it was found respectively: a) ejection fraction analysis (median): 64% and 60.5% for the total population (p = 0.25, 95% CI -2.7 to 10), 64% and 57.5% for anterior AMI (p = 0.2, 95% CI -3.6 to 16.3), 65% and 65% for inferior AMI (p = 0.99, 95% CI -8.4 to 8.4); b) global shortening analysis: -2.53 and -2.66 for the total population (p = 0.3, 95% CI -0.47 to 0.87), -2.27 and -2.53 for anterior AMI (p = 0.18, 95% CI -0.3 to 1.4), -1.82 and 1.72 for inferior AMI (p = 0.9, 95% CI -0.82 to 0.75); c) regional shortening analysis: anterior AMI -2.6 and -2.67 (p = 0.47, 95% CI -0.7 to 1.5), inferior AMI -2.3 and -2.32 (p = 0.9, 95% CI -0.82 to 0.75).

CONCLUSION

The dose of 750,000U was as efficacious as the 1.5 million relatively to LV systolic function, one of the best survival predictors of short-medium and long-term survival post AMI.