Intravenous tissue plasminogen activator and size of XXXX , left ventricular function, and survival in @entity583 .

@entity1 @entity932 @entity117 @entity2396 @entity1188 @entity2224 @entity299 @entity27216 @entity583 @entity1455 @entity204
STUDY OBJECTIVE: To assess effect of intravenous recombinant tissue type plasminogen activator on size of @entity1188 , left ventricular function, and survival in @entity583 . DESIGN: Double blind, randomised, placebo controlled prospective trial of @entity1 with @entity583 within five hours after onset of symptoms. SETTING: Twenty six referral centres participating in European cooperative study for recombinant tissue type plasminogen activator. @entity1 : Treatment group of 355 @entity1 with @entity583 allocated to receive intravenous recombinant plasminogen activator. Controls comprised 366 similar @entity1 allocated to receive placebo. INTERVENTION: All @entity1 were given @entity117 250 mg and bolus injection of 5000 IU heparin immediately before start of trial. @entity1 in treatment group were given 100 mg recombinant tissue plasminogen activator over three hours (10 mg intravenous bolus, 50 mg during one hour, and 40 mg during next two hours) by infusion. Controls were given placebo by same method. Full anticoagulation treatment and @entity117 were given to both groups until angiography (10-22 days after admission). beta Blockers were given at discharge. END POINT: Left ventricular function at 10-22 days, enzymatic @entity1188 size, clinical course, and survival to three month follow up. MEASUREMENTS AND MAIN RESULTS: Mortality was reduced by 51% (95% confidence interval -76 to 1) in treated @entity1 at 14 days after start of treatment and by 36% (-63 to 13) at three months. For treatment within three hours after @entity583 mortality was reduced by 82% (-95 to -31) at 14 days and by 59% (-83 to -2) at three months. During 14 days in hospital incidence of @entity299 was lower in treated @entity1 than controls ( @entity1455 , 2.5% v 6.0%; @entity2224 , 3.4% v 6.3%; and @entity2396 , 6.2% v 11.0% respectively), but that of angioplasty or artery bypass, or both was higher (15.8% v 9.6%) during the first three months. Bleeding complications were commoner in treated than untreated @entity1 . Most were minor, but 1.4% of treated @entity1 had @entity932 within three days after start of infusion. Enzymatic size of @entity1188 , determined by @entity27216 dehydrogenase concentrations, was less (20%, 2p = 0.0018) in treated @entity1 than in controls. Left ventricular ejection fraction was 2.2% higher (0.3 to 4.0) and end diastolic and end systolic volumes smaller by 6.0 ml (-0.2 to -11.9) and 5.8 ml (-0.9 to -10.6), respectively, in treated @entity1 . CONCLUSION: Recombinant tissue type plasminogen activator with heparin and @entity117 reduces size of @entity1188 , preserves left ventricular function, and reduces complications and @entity204 from cardiac causes but at increased risk of bleeding complications4+
