title: Accelerated streptokinase in ST-elevation myocardial infarction--a Romanian (ASK-ROMANIA) multicenter registry.
abstract: BACKGROUND
  The classical streptokinase regimen (1.5 M.U. over 60 min) may be too slow in patients with ST-elevation myocardial infarction (STEMI).
  
  
  OBJECTIVE
  To compare the efficacy and safety of four streptokinase regimens in STEMI patients.
  
  
  METHODS
  1880 consecutive patients admitted within 6 h of STEMI onset were allocated one of the following four streptokinase regimens: 1.5 M.U. over 60 min (n=517); 1.5 M.U./30 min (n=355); 1.5 M.U./20 min (n=507); 0.75 M.U./10 min, repeated or not after 50 min if no electrocardiographic criteria of reperfusion (n=501).
  
  
  RESULTS
  Rates of coronary reperfusion (non-invasively detected) for SK1.5/30 (72.39%), SK1.5/20 (75.34%) and SK0.75/10 (72.85%) were similar and higher than for SK1.5/60 (64.03%, p=0.019, p<0.0001, and p=0.006, respectively). In-hospital mortality was significantly lower for SK1.5/20 (7.10%) and SK0.75/10 (7.38%) and at the limit of significance for SK1.5/30 (7.60%) compared with SK1.5/60 (11.60%, p<0.0001, 0.006, and 0.053, respectively). Intracerebral haemorrhage and other major bleeding had similar incidence in the four groups.
  
  
  CONCLUSIONS
  Compared to the classical 1.5 M.U. over 60 min streptokinase regimen, significantly higher rates of coronary reperfusion and lower in-hospital mortality can be obtained by infusing the same dose over only 20 min, or either one or two half doses over only 10 min, without risk increase.
authors.affiliation: Spitalul Clinic de Urgenţă Floreasca, Clinica de Medicină Internă şi Cardiologie, Bucureşti, Romania. ro_stemi@yahoo.com
authors.forename: Gabriel
authors.initials: G
authors.lastname: Tatu-Chiţoiu
authors.forename: Maria
authors.initials: M
authors.lastname: Dorobanţu
authors.forename: Cristina
authors.initials: C
authors.lastname: Teodorescu
authors.forename: Elvira
authors.initials: E
authors.lastname: Craiu
authors.forename: Marius
authors.initials: M
authors.lastname: Vintilă
authors.forename: Bogdan
authors.initials: B
authors.lastname: Minescu
authors.forename: Daniel
authors.initials: D
authors.lastname: Burghină
authors.forename: Sorin
authors.initials: S
authors.lastname: Stamate
authors.forename: Luminiţa
authors.initials: L
authors.lastname: Serban
authors.forename: Tudor
authors.initials: T
authors.lastname: Protopopescu
authors.forename: Monica
authors.initials: M
authors.lastname: Dan
authors.forename: Petre
authors.initials: P
authors.lastname: Căpraru
authors.forename: Manuela
authors.initials: M
authors.lastname: Guran
authors.forename: Oana
authors.initials: O
authors.lastname: Istrătescu
authors.forename: Mircea
authors.initials: M
authors.lastname: Vlădoianu
authors.forename: Nicoleta
authors.initials: N
authors.lastname: Caea
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D015425:Myocardial Reperfusion / Q000379:methods; D012042:Registries; D012383:Romania; D013300:Streptokinase / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D013300:Streptokinase