COMPARING THROMBOLYTICS: STREPTOKINASE AND TPA HAVE SIMILAR EFFECTS.

It is now clear that intravenous thrombolytic therapy in the first 4 to 6 hours after the onset of chest pain is beneficial in most patients with acute myocardial infarction. But it is not clear which thrombolytic agent among the current competitors is best: recombinant tissue plasminogen activator (TPA), streptokinase, urokinase, pro- urokinase, or anisoylated streptokinase plasminogen activator complex (APSAC).

The two most widely used thrombolytics in the U.S. are TPA and streptokinase. Because TPA is more active in lysing new thrombi than streptokinase, some have argued that it should be more effective in lysing the coronary thrombosis and should be less likely to produce bleeding elsewhere.

This study from New Zealand randomized 270 cons…