41299 patients entering hospital up to 24 hr after the onset of symptoms of acute myocardial infarction were randomised to:
The study showed that there was no significant difference in the mortality and complication rates between the three thrombolytic groups.
There was a small, but significant, deficit in re-infarctions in the t-PA group. Streptokinase had a small but significant deficit in non-cerebral bleeds. APSAC and streptokinase were associated with a higher frequency of allergic and hypotensive episodes.
ISIS-3 suggests that the use of heparin and aspirin rather than aspirin alone resulted in a slightly lower mortality rate in the short-term (although there was no effect at 6 months).
Reference:
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