Duke University Clinical Cardiology Study - 2 - DUCCS-2
Aspirin dosing and thrombolytic therapy for reperfusion in acute MI.
Aspirin dosing and thrombolytic therapy in acute myocardial infarction.
Patients Screened: Not given
Patients Enrolled: 162
Age > 18 years
ST-segment elevation of ≥ 1 mV in at least 2 contiguous leads or new left bundle branch block
APSAC without heparin vs. rTPA with heparin; aspirin 81mg vs 325mg.
Patients randomized to APSAC without heparin (n=83) had more bleeding complications than patients given r-tPA with heparin (n=79).
Patients given r-tPA had more rapid clinical reperfusion (resolution of > 50% of ST-segment elevation) than patients randomized to APSAC.
Patients randomized to low-dose aspirin had lower in-hospital mortality compared to the standard-dose aspirin groups.
This head-to-head comparison of APSAC with r-tPA suggested that r-tPA had a more favorable net benefit over APSAC. Although a small study, DUCCS-2 can be considered hypothesis-generating. The ISIS-3 study demonstrated similar findings in a larger population sample.
1. Am J Cardiol 1996;77:791-7.
Keywords: Thrombolytic Therapy, Myocardial Infarction, Hospital Mortality, Streptokinase, Heparin, Bundle-Branch Block, Anistreplase, Tissue Plasminogen Activator
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