【医学课件】gustoi研究课件.ppt

GUSTO-I: Global Utilization of Streptokinase andt-PA for Occluded coronary arteries - I
Purpose
To compare an aggress and SK (1 million U over 60 min) and IV heparin (bolus 5000 U then 1000 U/h)
Accelerated t-PA (accelerated dose t-PA administered as bolus 15 mg, mg/kg over 30 min (max 50 mg) and mg/kg over 1h (max 35 mg)) and IV heparin (bolus 5000 U then 1000 U/h)
GUSTO-I: Global Utilization of Streptokinase andt-PA for Occluded coronary arteries - I - RESULTS -
Significant reduction in 30-day mortality with accelerated t-PA compared with the streptokinase (SK) and combination strategies
No significant difference between combination strategy and the two SK strategies (P=), or between the two SK strategies (P=)
Significant excess of hemorrhagic stroke for accelerated t-PA
(P=) and combination strategy (P<), compared with the two SK-only strategies
However, combined endpoint of death or disabling stroke significantly lower with accelerated t-PA than with SK-only strategies (% versus %; P=)
GUSTO-I: Global Utilization of Streptokinase andt-PA for Occluded coronary arteries - I - RESULTS continued -
The GUSTO Investigators.
N Engl J Med
1993;
329
:673
–
82.
Thirty-day mortality and stroke in the four treatment groups
Days after randomization
0
0
10
20
30
2
6
4
8
SK + IV heparin
SK + SC heparin
t-PA