fibrinolysis

systematic review meta-analysis network meta-analysis

Select acute coronary syndromeacute myocardial infarctioncardiac arrestpulmonary embolismvenous thrombosis >6h from onset of symptomsAll type of patientuncoded clinical condition ***       fibrinolysisfibrinolyticlocal fibrinolysissystemic fibrinolysis candesartananistreplaseAPSACheparinlanoteplasereteplasert-PAsaruplasestreptokinaset-patenecteplaseurokinase vs placebovs placebo or controlvs other fibrinolytic      

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Group by Group by... nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition MA  in first nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in second nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in third	Description Synopsis Comparison Treatments Patients Characteristics Method Risk of bias References None Tools Indexation					Results Global trial result Main results All results All result tag NCT results	Major bleeding (43)short term death (36)All cause death (20)stroke (fatal and non fatal) (18)Stroke/intracerebral bleeding (early) (10)recurrence of pulmonary embolism (10)Minor bleeding (10)Long term death (10)Bleeding (early) (9)Mortality (early) (7)Any improvement in venous patency (early) (7)myocardial infarction (fatal and non fatal) (7)reinfarction (7)Complete clot lysis (late) (6)In-hospital death (6)Pulmonary embolism (early) (4)Leg ulceration (late) (4)Complete clot lysis (early) (4)Post-thrombotic syndrome (late) (3)Bleeding (3)Normal venous function (late) (2)Survival to hospital discharge (2)Return of spontaneous circulation (2)Death before hospital discharge (2)Failure of return of spontaneous circulation (2)Haemmorhagic stroke (2)Mortality (late) (1)intracranial hemorrhage (1)ischemic stroke (1) Options Numeric bar chart forest plot medians
Trial	Studied trt	Control trt	patients	tags	ROB	Trial result	Major bleeding	short term death
acute coronary syndrome
anistreplase
UNASEM, 1992	anistreplase	placebo			Low risk of bias	-
t-pa
Topol, 1988	t-PA	placebo			Exploratory	negative
TIMI 3A, 1993	t-PA	placebo			Low risk of bias	-
Nicklas, 1989	t-PA	placebo			Low risk of bias	negative
Gold, 1987	t-PA	placebo			Exploratory	-
Williams, 1990	t-PA	placebo			Low risk of bias	negative
Freeman, 1992	t-PA	placebo			Low risk of bias	negative
van der Brand, 1991	t-PA	placebo			Low risk of bias	negative
charbonnier, 1992	t-PA	placebo			Low risk of bias	-
Ardissino, 1990	t-PA	placebo			Low risk of bias	negative
TIMI 3B, 1995	t-PA	placebo			Low risk of bias	-
acute myocardial infarction
anistreplase
TEAM 2, 1991	anistreplase	streptokinase			Low risk of bias	-
APSAC
APSIM, 1989	APSAC	control				negative
AIMS, 1988	APSAC	placebo			Low risk of bias	suggesting
German Multicenter Trial, 1988	APSAC	placebo				suggesting
ISIS III (SK/APSAC), 1992	APSAC	streptokinase			Low risk of bias	negative
TEAM 3, 1992	APSAC	t-PA			Low risk of bias	-
lanoteplase
InTIME-II, 2000	lanoteplase	accelerated t-PA			Low risk of bias	negative
reteplase
RAPID-2, 1996	reteplase	accelerated t-PA			Exploratory	suggesting
GUSTO III, 1997	reteplase	accelerated t-PA				negative
INJECT, 1995	reteplase	streptokinase			Low risk of bias	negative
saruplase
PRIMI (vs SK), 1989	saruplase	streptokinase			Low risk of bias	-
COMPASS, 1998	saruplase	streptokinase			Low risk of bias	negative
SESAM, 1997	saruplase	t-PA			Exploratory	negative
PRIMI (vs UK), 1989	saruplase	urokinase			Low risk of bias	-
streptokinase
ISIS-2 (SK), 1988	streptokinase	placebo			Low risk of bias	suggesting
ISAM, 1986	streptokinase	placebo			Low risk of bias	negative
EMERAS (7-12h), 1993	streptokinase	placebo			Low risk of bias	-
EMERAS (all delay), 1993	streptokinase	placebo			Low risk of bias	negative
ISIS 2 pilot, 1987	streptokinase	placebo			Low risk of bias	-
Western Washington Intravenous Trial, 1988    NCT	streptokinase	placebo				negative
GISSI I, 1986	streptokinase	placebo				suggesting
GUSTO tPA-SK Hiv, 1993	t-PA + streptokinase	streptokinase				negative
t-pa
TAMI 6, 1992	t-PA	placebo			Low risk of bias	negative
LATE, 1993	t-PA	placebo			Low risk of bias	negative
ASSET, 1988	t-PA	placebo			Low risk of bias	suggesting
COBALT, 1997	bolus t-PA	accelerated t-PA			Low risk of bias	negative
TIMI 4, 1994	accelerated t-PA	APSAC			Low risk of bias	-
TAPS, 1992	accelerated t-PA	APSAC				negative
GUSTO tPA Hiv, 1993	accelerated t-PA	streptokinase				suggesting
ISIS III (SK/tPA), 1992	t-PA	streptokinase			Low risk of bias	suggesting
White, 1989	t-PA	streptokinase			Low risk of bias	-
TIMI-1, 1987    NCT	t-PA	streptokinase			Low risk of bias	-
ECSG, 1985	t-PA	streptokinase				negative
GISSI II, 1990	t-PA	streptokinase				suggesting
International Study Group, 1990	t-PA	streptokinase			Low risk of bias	suggesting
PAIMS, 1989	t-PA	streptokinase				-
Centre Illinois, 1993	t-PA	streptokinase				-
Cherng, 1992	t-PA	streptokinase				negative
RAAMI, 1992	accelerated t-PA	t-PA				-
KAMIT, 1991	t-PA half dose	t-PA			Exploratory	negative
TAMI 5 (t-PA vs uroK), 1991	t-PA	urokinase				-
tenecteplase
ASSENT-2, 1999	tenecteplase	accelerated t-PA			Low risk of bias	suggesting
urokinase
USIM, 1991	urokinase	control				-
cardiac arrest
t-pa
Abu-Laban, 2002	t-PA	placebo			Low risk of bias	negative
tenecteplase
TROICA, 2008      NCT	tenecteplase	placebo			Low risk of bias	negative
TICA, 2004	tenecteplase	placebo			Low risk of bias	negative
pulmonary embolism
candesartan
Tebbe, 2009	desmoteplase	alteplase			Exploratory	-
rt-PA
Goldhaber, 1993	rt-PA	no fibrinolysis			Exploratory	negative
PAIMS 2, 1992	rt-PA	no fibrinolysis			Exploratory	negative
Konstantinides, 2002	rt-PA	placebo			Low risk of bias	negative
Levine, 1990	rt-PA	placebo			Low risk of bias	negative
PIOPED, 1990	rt-PA	placebo			Low risk of bias	negative
streptokinase
Ly, 1978	streptokinase	no fibrinolysis			Exploratory	negative
Tibbutt, 1974	streptokinase	no fibrinolysis			Exploratory	negative
Jerjes-Sanchez, 1995	streptokinase	no fibrinolysis			Exploratory	-
urokinase
Marini, 1988	urokinase	no fibrinolysis			Exploratory	-
UPET, 1973	urokinase	placebo			Low risk of bias	negative
venous thrombosis
heparin
Schweizer tPA, 1998	tPA+heparin	no fibrinolysis				negative
streptokinase
Schulman, 1986	streptokinase	no fibrinolysis				negative
Elsharawy, 2002	streptokinase	no fibrinolysis				negative
Kakkar (streptokinase), 1969	streptokinase	no fibrinolysis				negative
Common, 1976	streptokinase	no fibrinolysis				negative
Tsapogas, 1973	streptokinase	no fibrinolysis				negative
Schweizer (systemic SK), 2000	streptokinase	no fibrinolysis				-
Arneson, 1978	streptokinase	no fibrinolysis				negative
t-pa
Goldhaber (tPA alone), 1990	tPA	no fibrinolysis				negative
Verhaeghe (low dose), 1989	tPA	no fibrinolysis			Low risk of bias	-
Goldhaber (tPA+heparin), 1990	tPA	no fibrinolysis				-
Turpie, 1990	tPA	no fibrinolysis			Low risk of bias	negative
Schweizer (local tPA), 2000	tPA	no fibrinolysis				-
Verhaeghe (high dose), 1989	tPA	no fibrinolysis			Low risk of bias	-
urokinase
Schweizer (systemic urokinase), 2000	urokinase	no fibrinolysis				-
Kiil, 1981	urokinase	no fibrinolysis			Low risk of bias	negative
Schweizer (local urokinase), 2000	urokinase	no fibrinolysis				-
Schweizer (urokinase), 1998	urokinase	no fibrinolysis				negative