[Thrombolytic therapy in acute ischemic stroke with streptokinase].
OBJECTIVE
In an open, observational study, 40 consecutive ischemic stroke patients eligible for thrombolytic therapy using the combined ECASS/NINDS inclusion criteria have been treated intravenously with 1.5 M units of streptokinase. The therapeutic window was 3 hours or shorter.


RESULTS
The safety analysis documented a low rate (5%) of intracerebral hemorrhages, and an additional 13% rate of hemorrhagic transformation of the initial infarction. Two patients died due to intracerebral bleeding. The efficacy of the SK thrombolysis was significant in 53% of the patients (the mean of the improvement on the NIH stroke scale was 15 points), while an other 42% of the patients achieved only the mean of 4 points improvement on their NIHSS score.


CONCLUSIONS
These results are of the same magnitude, as those documented in the NINDS trial with rt-PA. Time window rather than the thrombolytic agent itself seems to be the decisive factor for successful thrombolysis.


CONCLUSIONS
The good safety profile of SK in acute stroke using the ECASS/NINDS criteria, and the cost-effectiveness of the drug underline the necessity of a new SK trial with the recently accepted inclusion and exclusion criteria.
Agyérbetegségek Országos Központja, Budapest.
Norbert
N
Szegedi
Ilona
I
Kakuk
Júlia
J
Kenéz
Zsolt
Z
May
Csaba
C
Ováry
Gabriella
G
Ricsóy
Judit
J
Skopál
Dániel
D
Varga
Adám
A
Harsányi
Zoltán
Z
Nagy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D000075202:Contraindications; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D013300:Streptokinase / Q000008:administration & dosage*; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D013300:Streptokinase; D010960:Plasminogen Activators