AustralieFrV1, Main, Exploration, bibRecord, 00C117

Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction : Results from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III Trial

Identifieur interne : 00C117 ( Main/Exploration ); précédent : 00C116; suivant : 00C118

Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction : Results from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III Trial

Auteurs : Eric J. Topol [États-Unis] ; E. Magnus Ohman [États-Unis] ; Paul W. Armstrong [Canada] ; Robert Wilcox [Royaume-Uni] ; Alan M. Skene [Royaume-Uni] ; Philip Aylward [Australie] ; John Simes [Australie] ; Anthony Dalby [Afrique du Sud] ; Amadeo Betriu [Espagne] ; Christoph Bode [Allemagne] ; Harvey D. White [Nouvelle-Zélande] ; Judith S. Hochman [États-Unis] ; Hakan Emanuelson [Royaume-Uni] ; Alec Vahanian [France] ; Shelly Sapp [États-Unis] ; Amanda Stebbins [États-Unis] ; David J. Moliterno [États-Unis] ; Robert M. Califf [États-Unis]

Source :

Circulation : (New York, N.Y.) [ 0009-7322 ] ; 2000.

RBID : Pascal:00-0521832

Descripteurs français

Pascal (Inist)
- Infarctus, Myocarde, Aigu, Altéplase, Rétéplase, Streptokinase, Chimiothérapie, Traitement, Pronostic, Homme, Etude longitudinale, Fibrinolytique.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Acute, Alteplase, Chemotherapy, Fibrinolytic, Follow up study, Human, Infarct, Myocardium, Prognosis, Reteplase, Streptokinase, Treatment.

Abstract

Background-New recombinant plasminogen activators have been developed to simulate the fibrinolytic action of the physiological serine protease tissue plasminogen activator (alteplase, t-PA), and have prolonged half-life features permitting bolus administration. One such activator, reteplase (r-PA), was compared with t-PA in the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-III Trial. Methods and Results-At 1-year follow-up, survival status was ascertained in 97.4% of the 15 059 patients enrolled in the GUSTO-III trial. At 1 year, the mortality rate for the t-PA-assigned group was 11.06%, and for r-PA it was 11.20% (P=0.77). The absolute mortality difference of 0.14% has 95% CIs of - 1.21% to 0.93%. There were no significant differences in outcome by intention-to-treat for the 2 different plasminogen activators in the prespecified groups (age, infarct location, time-to-treatment). The absolute difference in mortality rates between t-PA and r-PA progressively narrowed over the predetermined observation times after random assignment; it was 0.31% at 24 hours, 0.26% at 7 days, 0.23% at 30 days, and 0.14% at I year. Of note, mortality rate in the trial between 30 days and I year in 13 883 patients was 4.02% and did not differ between the treatment groups. However, this mortality rate was substantially greater than in GUSTO-I, in which mortality rate for t-PA versus streptokinase between 30 days and 1-year was 2.97% (heart rate 1.36, 95% CI 1.23, 1.50, P<0.001). Conclusions-The r-PA and t-PA strategies yielded similar survival outcomes after 30 days in this trial. The increase in mortality rate during extended follow-up compared with previous trials may reflect higher-risk patients and highlights the need for improved secondary prevention strategies.

Affiliations:

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Le document en format XML

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<author><name sortKey="Moliterno, David J" sort="Moliterno, David J" uniqKey="Moliterno D" first="David J." last="Moliterno">David J. Moliterno</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction : Results from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III Trial</title>
<author><name sortKey="Topol, Eric J" sort="Topol, Eric J" uniqKey="Topol E" first="Eric J." last="Topol">Eric J. Topol</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>The Cleveland Clinic Foundation</s1>
<s2>Cleveland, Ohio</s2>
<s3>USA</s3>
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<placeName><region type="state">Ohio</region>
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</affiliation>
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<author><name sortKey="Ohman, E Magnus" sort="Ohman, E Magnus" uniqKey="Ohman E" first="E. Magnus" last="Ohman">E. Magnus Ohman</name>
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<author><name sortKey="Armstrong, Paul W" sort="Armstrong, Paul W" uniqKey="Armstrong P" first="Paul W." last="Armstrong">Paul W. Armstrong</name>
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</inist:fA14>
<country>Canada</country>
<wicri:noRegion>University of Alberta</wicri:noRegion>
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<author><name sortKey="Wilcox, Robert" sort="Wilcox, Robert" uniqKey="Wilcox R" first="Robert" last="Wilcox">Robert Wilcox</name>
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<author><name sortKey="Skene, Alan M" sort="Skene, Alan M" uniqKey="Skene A" first="Alan M." last="Skene">Alan M. Skene</name>
<affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Nottingham Clinical Trials Data Center</s1>
<s2>Nottingham</s2>
<s3>GBR</s3>
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<author><name sortKey="Aylward, Philip" sort="Aylward, Philip" uniqKey="Aylward P" first="Philip" last="Aylward">Philip Aylward</name>
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<author><name sortKey="Simes, John" sort="Simes, John" uniqKey="Simes J" first="John" last="Simes">John Simes</name>
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<author><name sortKey="Dalby, Anthony" sort="Dalby, Anthony" uniqKey="Dalby A" first="Anthony" last="Dalby">Anthony Dalby</name>
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<author><name sortKey="Betriu, Amadeo" sort="Betriu, Amadeo" uniqKey="Betriu A" first="Amadeo" last="Betriu">Amadeo Betriu</name>
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<author><name sortKey="Bode, Christoph" sort="Bode, Christoph" uniqKey="Bode C" first="Christoph" last="Bode">Christoph Bode</name>
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<author><name sortKey="White, Harvey D" sort="White, Harvey D" uniqKey="White H" first="Harvey D." last="White">Harvey D. White</name>
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<author><name sortKey="Hochman, Judith S" sort="Hochman, Judith S" uniqKey="Hochman J" first="Judith S." last="Hochman">Judith S. Hochman</name>
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<author><name sortKey="Emanuelson, Hakan" sort="Emanuelson, Hakan" uniqKey="Emanuelson H" first="Hakan" last="Emanuelson">Hakan Emanuelson</name>
<affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Astra Charnwood Clinical R & D</s1>
<s2>Loughborough</s2>
<s3>GBR</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Astra Charnwood Clinical R & D</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Vahanian, Alec" sort="Vahanian, Alec" uniqKey="Vahanian A" first="Alec" last="Vahanian">Alec Vahanian</name>
<affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Hospital Bichat</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sapp, Shelly" sort="Sapp, Shelly" uniqKey="Sapp S" first="Shelly" last="Sapp">Shelly Sapp</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>The Cleveland Clinic Foundation</s1>
<s2>Cleveland, Ohio</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Stebbins, Amanda" sort="Stebbins, Amanda" uniqKey="Stebbins A" first="Amanda" last="Stebbins">Amanda Stebbins</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Duke University</s1>
<s2>Durham, NC</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>16 aut.</sZ>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Duke University</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Moliterno, David J" sort="Moliterno, David J" uniqKey="Moliterno D" first="David J." last="Moliterno">David J. Moliterno</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>The Cleveland Clinic Foundation</s1>
<s2>Cleveland, Ohio</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Califf, Robert M" sort="Califf, Robert M" uniqKey="Califf R" first="Robert M." last="Califf">Robert M. Califf</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Duke University</s1>
<s2>Durham, NC</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>16 aut.</sZ>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Duke University</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Circulation : (New York, N.Y.)</title>
<title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title>
<idno type="ISSN">0009-7322</idno>
<imprint><date when="2000">2000</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Circulation : (New York, N.Y.)</title>
<title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title>
<idno type="ISSN">0009-7322</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute</term>
<term>Alteplase</term>
<term>Chemotherapy</term>
<term>Fibrinolytic</term>
<term>Follow up study</term>
<term>Human</term>
<term>Infarct</term>
<term>Myocardium</term>
<term>Prognosis</term>
<term>Reteplase</term>
<term>Streptokinase</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Infarctus</term>
<term>Myocarde</term>
<term>Aigu</term>
<term>Altéplase</term>
<term>Rétéplase</term>
<term>Streptokinase</term>
<term>Chimiothérapie</term>
<term>Traitement</term>
<term>Pronostic</term>
<term>Homme</term>
<term>Etude longitudinale</term>
<term>Fibrinolytique</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background-New recombinant plasminogen activators have been developed to simulate the fibrinolytic action of the physiological serine protease tissue plasminogen activator (alteplase, t-PA), and have prolonged half-life features permitting bolus administration. One such activator, reteplase (r-PA), was compared with t-PA in the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-III Trial. Methods and Results-At 1-year follow-up, survival status was ascertained in 97.4% of the 15 059 patients enrolled in the GUSTO-III trial. At 1 year, the mortality rate for the t-PA-assigned group was 11.06%, and for r-PA it was 11.20% (P=0.77). The absolute mortality difference of 0.14% has 95% CIs of - 1.21% to 0.93%. There were no significant differences in outcome by intention-to-treat for the 2 different plasminogen activators in the prespecified groups (age, infarct location, time-to-treatment). The absolute difference in mortality rates between t-PA and r-PA progressively narrowed over the predetermined observation times after random assignment; it was 0.31% at 24 hours, 0.26% at 7 days, 0.23% at 30 days, and 0.14% at I year. Of note, mortality rate in the trial between 30 days and I year in 13 883 patients was 4.02% and did not differ between the treatment groups. However, this mortality rate was substantially greater than in GUSTO-I, in which mortality rate for t-PA versus streptokinase between 30 days and 1-year was 2.97% (heart rate 1.36, 95% CI 1.23, 1.50, P<0.001). Conclusions-The r-PA and t-PA strategies yielded similar survival outcomes after 30 days in this trial. The increase in mortality rate during extended follow-up compared with previous trials may reflect higher-risk patients and highlights the need for improved secondary prevention strategies.</div>
</front>
</TEI>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Allemagne</li>
<li>Australie</li>
<li>Canada</li>
<li>Espagne</li>
<li>France</li>
<li>Nouvelle-Zélande</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Bade-Wurtemberg</li>
<li>Catalogne</li>
<li>District de Karlsruhe</li>
<li>Nouvelle-Galles du Sud</li>
<li>Ohio</li>
<li>Île-de-France</li>
</region>
<settlement><li>Barcelone</li>
<li>Heidelberg</li>
<li>Paris</li>
<li>Sydney</li>
</settlement>
<orgName><li>Université de Sydney</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="Ohio"><name sortKey="Topol, Eric J" sort="Topol, Eric J" uniqKey="Topol E" first="Eric J." last="Topol">Eric J. Topol</name>
</region>
<name sortKey="Califf, Robert M" sort="Califf, Robert M" uniqKey="Califf R" first="Robert M." last="Califf">Robert M. Califf</name>
<name sortKey="Hochman, Judith S" sort="Hochman, Judith S" uniqKey="Hochman J" first="Judith S." last="Hochman">Judith S. Hochman</name>
<name sortKey="Moliterno, David J" sort="Moliterno, David J" uniqKey="Moliterno D" first="David J." last="Moliterno">David J. Moliterno</name>
<name sortKey="Ohman, E Magnus" sort="Ohman, E Magnus" uniqKey="Ohman E" first="E. Magnus" last="Ohman">E. Magnus Ohman</name>
<name sortKey="Sapp, Shelly" sort="Sapp, Shelly" uniqKey="Sapp S" first="Shelly" last="Sapp">Shelly Sapp</name>
<name sortKey="Stebbins, Amanda" sort="Stebbins, Amanda" uniqKey="Stebbins A" first="Amanda" last="Stebbins">Amanda Stebbins</name>
</country>
<country name="Canada"><noRegion><name sortKey="Armstrong, Paul W" sort="Armstrong, Paul W" uniqKey="Armstrong P" first="Paul W." last="Armstrong">Paul W. Armstrong</name>
</noRegion>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Wilcox, Robert" sort="Wilcox, Robert" uniqKey="Wilcox R" first="Robert" last="Wilcox">Robert Wilcox</name>
</noRegion>
<name sortKey="Emanuelson, Hakan" sort="Emanuelson, Hakan" uniqKey="Emanuelson H" first="Hakan" last="Emanuelson">Hakan Emanuelson</name>
<name sortKey="Skene, Alan M" sort="Skene, Alan M" uniqKey="Skene A" first="Alan M." last="Skene">Alan M. Skene</name>
</country>
<country name="Australie"><noRegion><name sortKey="Aylward, Philip" sort="Aylward, Philip" uniqKey="Aylward P" first="Philip" last="Aylward">Philip Aylward</name>
</noRegion>
<name sortKey="Simes, John" sort="Simes, John" uniqKey="Simes J" first="John" last="Simes">John Simes</name>
</country>
<country name="Afrique du Sud"><noRegion><name sortKey="Dalby, Anthony" sort="Dalby, Anthony" uniqKey="Dalby A" first="Anthony" last="Dalby">Anthony Dalby</name>
</noRegion>
</country>
<country name="Espagne"><region name="Catalogne"><name sortKey="Betriu, Amadeo" sort="Betriu, Amadeo" uniqKey="Betriu A" first="Amadeo" last="Betriu">Amadeo Betriu</name>
</region>
</country>
<country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Bode, Christoph" sort="Bode, Christoph" uniqKey="Bode C" first="Christoph" last="Bode">Christoph Bode</name>
</region>
</country>
<country name="Nouvelle-Zélande"><noRegion><name sortKey="White, Harvey D" sort="White, Harvey D" uniqKey="White H" first="Harvey D." last="White">Harvey D. White</name>
</noRegion>
</country>
<country name="France"><region name="Île-de-France"><name sortKey="Vahanian, Alec" sort="Vahanian, Alec" uniqKey="Vahanian A" first="Alec" last="Vahanian">Alec Vahanian</name>
</region>
</country>
</tree>
</affiliations>
</record>

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Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction : Results from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III Trial

Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction : Results from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III Trial

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