1986Acute coronary syndromes11806 patients

GISSI-1

Therapy group: Thrombolysis · Therapy: Streptokinase

Intravenous streptokinase reduced mortality in acute myocardial infarction, especially when given within the first hours.

Published in Lancet (1986)

Question: Does early intravenous streptokinase in acute myocardial infarction reduce in-hospital mortality?
Design: Randomized, unblinded, multicenter trial in coronary care units that enrolled 11 806 patients over 17 months; complete data were obtained in 11 712.
Population: Patients with acute myocardial infarction admitted within 12 hours of symptom onset and with no contraindications to streptokinase.
Intervention: Intravenous streptokinase in addition to usual treatment.
Control: Usual treatment alone, without streptokinase.
Primary outcome: In-hospital mortality at 21 days.
Results: In-hospital mortality at 21 days was 10.7% with streptokinase versus 13% in controls, an 18% reduction (RR 0.81; p = 0.0002). The benefit depended on time to infusion: RR 0.74, 0.80, 0.87 and 1.19 in the 0-3, 3-6, 6-9 and 9-12 hour subgroups.
Safety: The authors conclude that streptokinase appears to be a safe drug for routine administration in acute myocardial infarction.
Conclusion: Intravenous streptokinase reduced in-hospital mortality in acute myocardial infarction, with greater benefit the earlier it was given.
Why it matters: It showed in a large trial that intravenous thrombolysis improves survival in acute infarction and that time to treatment is decisive, laying the groundwork for early reperfusion as the standard of care.

Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.

Generated on October 7, 2026

Sources

Original publication on PubMed (PMID 2868337) ↗Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico (GISSI).

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