| acute myocardial infarction | versus other fibrinolytic No demonstrated result for efficacy | 3 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| GUSTO III, 1997 | reteplase vs accelerated t-PA | | | Hémorragies majeures précoces 0.79 [0.57; 1.09] Mortalité précoce 1.03 [0.91; 1.17] AVC précoce 0.92 [0.71; 1.18] | | INJECT, 1995 | reteplase vs streptokinase | | | Mortalité précoce 0.95 [0.81; 1.11] AVC précoce 1.23 [0.76; 1.99] | | RAPID-2, 1996 | reteplase vs accelerated t-PA | total patency (TIMI 2 or 3) 1.14 [1.01; 1.28] complete patency (TIMI 3) 1.32 [1.06; 1.65] | | total stroke 0.69 [0.16; 3.02] Hémorragies majeures précoces 1.28 [0.69; 2.40] Haemorraghic stroke 0.61 [0.10; 3.61] Mortalité précoce 0.49 [0.20; 1.21] AVC précoce 0.69 [0.16; 3.02] reinfarction 1.05 [0.39; 2.82] |
| Trial | Treatments | Patients | Method |
|---|
| GUSTO III, 1997 | reteplase, in two bolus doses or 10 MU each given 30 minutes apart (n=10138) vs. alteplase, up to 100 mg infused over a period of 90 minutes (n=4921) | patients within 6 hours after the onset of symptoms with ST-segment elevation or bundle-branch block | open Parallel groups Sample size: 10138/4921 Primary endpoint: Mortality 30-day FU duration: 30 days | | INJECT, 1995 | Reteplase 2 bolus de 10 MU à 30 min d'intervalle (n=3004) vs. Streptokinase 1.5 MU en IV en 60 min (n=3006) | patients with symptoms and electrocardiographic criteria consistent with acute myocardial infarction within 12 h from onset of symptoms | double blind Parallel groups Sample size: 3004/3006 Primary endpoint: Mortality 35-day FU duration: 6 mo | | RAPID-2, 1996 | 10 plus 10 megaunits double bolus of reteplase (n=169) vs. front-loaded alteplase (n=155) | patients with acute myocardial infarction within 12h from onset of ischemic chest pain | open Parallel groups Sample size: 169/155 Primary endpoint: Patency at 90 min FU duration: 35 days |
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