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Editorial
. 2002 Apr;87(4):308-11.
doi: 10.1136/heart.87.4.308.

Fibrinolytic treatment for elderly patients with acute myocardial infarction

J M Estess, E J Topol
Editorial

Fibrinolytic treatment for elderly patients with acute myocardial infarction

J M Estess et al. Heart. 2002 Apr.
No abstract available

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Figures

Figure 1
Figure 1
Absolute benefit with streptokinase (SK) versus conservative treatment by age in the GISSI-1 and ISIS-2 trials. Adapted from: The ISIS Collaborative group. Optimizing thrombolytic therapy of acute myocardial infarction: age is not a contraindication. Circulation 1991;84(suppl II):II-230 (with permission).
Figure 2
Figure 2
Revised FTT data: patients randomised with proven indications for thrombolysis (that is, ST elevation, new bundle branch block, within 12 hours onset). Excludes patients presenting > 12 hours, with normal ECG, with only T wave inversion or ST depression which were included in the original FTT meta-analysis. (H White, personal communication.) *Original FTT data.12
Figure 3
Figure 3
Odds ratios and 95% confidence intervals for the risk of death, haemorrhagic stroke, and death or disabling stroke at 30 days: treatment with accelerated tissue plasminogen activator (t-PA) and intravenous heparin versus streptokinase and subcutaneous heparin. From White et al. Age and outcome with contemporary thrombolytic therapy results from the GUSTO-I trial. Circulation 1996;94:1826–33 (with permission).13
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References

    1. Topol EJ, Califf RM. Thrombolytic therapy for elderly patients [editorial]. N Engl J Med 1992;327:45–7. - PubMed
    1. Thiemann DR, Coresh J, Schulman SP, et al. Lack of benefit for intravenous thrombolysis in patients with myocardial infarction who are older than 75 years. Circulation 2000;101:2239–46. - PubMed
    1. Gruppo Italiano per lo Studio della Streptochinasi nell'Infarcto miocardico (GISSI). Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1986;i:397–401. - PubMed
    1. Second International Study of Infarct Survival Collaborative Group (ISIS-2). Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction. Lancet 1988;ii:349–60. - PubMed
    1. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarcto Miocaridco (GISSI-2). A factorial randomized trial of alteplase versus streptokinase and heparin versus no heparin among 12,490 patients with acute myocardial infarction. Lancet 1990;336:65–71. - PubMed

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