| treatment |
|
comparator |
All cause death | Bleeding | Cardiovascular death | Long term death | Major bleeding | Major bleeding | Minor bleeding | Haemmorhagic stroke | ischemic stroke | intracranial hemorrhage | short term death | Deaths or MI | In hospital death or MI | stroke (fatal and non fatal) | myocardial infarction (fatal and non fatal) | reinfarction | In-hospital death | Complete clot lysis (early) | Mortality (early) | Pulmonary embolism (early) | Bleeding (early) | Any improvement in venous patency (early) | Normal venous function (late) | Complete clot lysis (late) | Post-thrombotic syndrome (late) | Mortality (late) | Leg ulceration (late) | Stroke/intracerebral bleeding (early) | recurrence of pulmonary embolism | Survival to hospital discharge | Return of spontaneous circulation | Failure of return of spontaneous circulation | Death before hospital admission | Death before hospital discharge |
|
|
| APSAC | acute myocardial infarction, in all type of patients | vs control | - | - | - | - | - | - | - | - | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 1.24 [0.40 3.81] | p=1.00 | 0 | 231 | 1 | APSIM, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| APSIM, 1989 | APSAC 30 U over 5 min | control (conventional heparin therapy, 5,000 IU in a bolus injection) | patients with a first acute myocardial infarction within 5 h after the onset of symptoms |
|
| APSAC | acute myocardial infarction, in all type of patients | vs placebo | - | - | - | by 38% | NS | NS | - | - | - | - | by 49% | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | 0.62 [0.45 0.86] | p=0.04 | 0 | 1258 | 1 | AIMS, | | Major bleeding | 1.43 [0.63 3.26] | p=1.00 | 0 | 1571 | 2 | AIMS, German Multicenter Trial, | | Major bleeding | 1.43 [0.63 3.26] | p=1.00 | 0 | 1571 | 2 | AIMS, German Multicenter Trial, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.51 [0.36 0.73] | p=0.04 | 0 | 1571 | 2 | AIMS, German Multicenter Trial, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.02 [0.25 4.08] | p=1.00 | 0 | 1258 | 1 | AIMS, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| AIMS, 1988 | APSAC 30U IV in 5 min | Placebo | Hommes et femmes, < 70 ans | | German Multicenter Trial, 1988 | APSAC 30 unités en IV en 5 min, puis héparine en IV (17 U/kg/h) 4 h après linjection dAPSAC | Héparine 5000 U en bolus en IV, puis 17 U/kg/h | Hommes et femmes, < 70 ans |
|
| APSAC | acute myocardial infarction, in all type of patients | vs streptokinase | - | - | - | NS | NS | NS | - | - | - | - | NS | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | 1.02 [0.95 1.09] | p=1.00 | 0 | 27553 | 1 | ISIS III (SK/APSAC), | | Major bleeding | 0.85 [0.67 1.09] | p=1.00 | 0 | 27553 | 1 | ISIS III (SK/APSAC), | | Major bleeding | 0.85 [0.67 1.09] | p=1.00 | 0 | 27553 | 1 | ISIS III (SK/APSAC), | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 1.00 [0.93 1.08] | p=1.00 | 0 | 27553 | 1 | ISIS III (SK/APSAC), | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 0.82 [0.65 1.02] | p=1.00 | 0 | 27553 | 1 | ISIS III (SK/APSAC), | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| ISIS III (SK/APSAC), 1992 | Streptokinase 1.5 MU infused over about 1 h | anisoylated plasminogen-streptokinase activator complex (APSAC), anistreplase: 30 U over about 3 min | patients within 24 h of the onset of suspected acute myocardial infarction |
|
| APSAC | acute myocardial infarction, in all type of patients | vs t-PA | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| TEAM 3, 1992 | APSAC, 30 U/2 to 5 min | rt-PA, 100 mg/3 h, | patient with ST elevalation within 4h of the onset of symptoms |
|
| Lanoteplase | acute myocardial infarction, in all type of patients | vs accelerated t-PA | - | - | - | NS | NS | NS | - | - | - | - | NS | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | 0.97 [0.87 1.09] | p=1.00 | 0 | 15060 | 1 | InTIME-II, | | Major bleeding | 0.83 [0.53 1.31] | p=1.00 | 0 | 15060 | 1 | InTIME-II, | | Major bleeding | 0.83 [0.53 1.31] | p=1.00 | 0 | 15060 | 1 | InTIME-II, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 1.02 [0.89 1.17] | p=1.00 | 0 | 15060 | 1 | InTIME-II, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.22 [0.93 1.60] | p=1.00 | 0 | 15060 | 1 | InTIME-II, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| InTIME-II, 2000 | lanoteplase 120 KU. kg(-1) as a single intravenous bolus | up to 100 mg accelerated alteplase given over 90 min | patients presenting within 6 h of onset of ST elevation acute myocardial infarction |
|
| Reteplase | acute myocardial infarction, in all type of patients | vs accelerated t-PA | - | - | - | - | NS | NS | - | NS | - | - | NS | - | - | NS | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 0.86 [0.64 1.16] | p=1.00 | 0 | 15383 | 2 | GUSTO III, RAPID-2, | | Major bleeding | 0.86 [0.64 1.16] | p=1.00 | 0 | 15383 | 2 | GUSTO III, RAPID-2, | | Minor bleeding | no data | | Haemmorhagic stroke | 0.61 [0.10 3.71] | p=1.00 | 0 | 324 | 1 | RAPID-2, | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 1.02 [0.89 1.16] | p=1.00 | 0 | 15383 | 2 | GUSTO III, RAPID-2, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 0.91 [0.70 1.17] | p=1.00 | 0 | 15383 | 2 | GUSTO III, RAPID-2, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | 1.05 [0.37 2.96] | p=1.00 | 0 | 324 | 1 | RAPID-2, | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| GUSTO III, 1997 | reteplase, in two bolus doses or 10 MU each given 30 minutes apart | alteplase, up to 100 mg infused over a period of 90 minutes | patients within 6 hours after the onset of symptoms with ST-segment elevation or bundle-branch block | | RAPID-2, 1996 | 10 plus 10 megaunits double bolus of reteplase | front-loaded alteplase | patients with acute myocardial infarction within 12h from onset of ischemic chest pain |
|
| Reteplase | acute myocardial infarction, in all type of patients | vs streptokinase | - | - | - | - | - | - | - | - | - | - | NS | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.95 [0.80 1.13] | p=1.00 | 0 | 6010 | 1 | INJECT, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.23 [0.76 2.00] | p=1.00 | 0 | 6010 | 1 | INJECT, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| INJECT, 1995 | Reteplase 2 bolus de 10 MU à 30 min dintervalle | Streptokinase 1.5 MU en IV en 60 min | patients with symptoms and electrocardiographic criteria consistent with acute myocardial infarction within 12 h from onset of symptoms |
|
| Saruplase | acute myocardial infarction, in all type of patients | vs streptokinase | - | - | - | NS | NS | NS | - | - | - | - | NS | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | 0.86 [0.67 1.10] | p=1.00 | 0 | 3089 | 1 | COMPASS, | | Major bleeding | 0.84 [0.53 1.36] | p=1.00 | 0 | 3089 | 1 | COMPASS, | | Major bleeding | 0.84 [0.53 1.36] | p=1.00 | 0 | 3089 | 1 | COMPASS, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.85 [0.63 1.14] | p=1.00 | 0 | 3089 | 1 | COMPASS, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.00 [0.55 1.82] | p=1.00 | 0 | 3089 | 1 | COMPASS, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| COMPASS, 1998 | saruplase 20-mg bolus and 60-mg infusion over 60 min | streptokinase 1.5-MU infusion over 60 min | patients with symptoms compatible with those of acute myocardial infarction for < 6 h | | PRIMI (vs SK), 1989 | sarupalse 20 mg bolus followed by 60 mg infusion for 60 min | 1.5 million IU streptokinase infused over 60 min | patients with acute myocardial infarction were within 4 h of onset of symptoms |
|
| Saruplase | acute myocardial infarction, in all type of patients | vs t-PA | - | - | - | - | NS | NS | - | NS | - | - | NS | - | - | NS | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 1.10 [0.59 2.08] | p=1.00 | 0 | 473 | 1 | SESAM, | | Major bleeding | 1.10 [0.59 2.08] | p=1.00 | 0 | 473 | 1 | SESAM, | | Minor bleeding | no data | | Haemmorhagic stroke | 1.00 [0.14 7.19] | p=1.00 | 0 | 473 | 1 | SESAM, | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 1.23 [0.50 3.02] | p=1.00 | 0 | 473 | 1 | SESAM, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 0.80 [0.21 3.03] | p=1.00 | 0 | 473 | 1 | SESAM, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | 1.00 [0.41 2.46] | p=1.00 | 0 | 473 | 1 | SESAM, | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| SESAM, 1997 | saruplase 80 mg/hour | alteplase 100 mg every 3 hours | patients with acute myocardial infarction |
|
| Saruplase | acute myocardial infarction, in all type of patients | vs urokinase | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| PRIMI (vs UK), 1989 | 20 mg bolus followed by 60 mg infusion for 60 min | 80 mg recombinant pro-urokinase | with a first acute myocardial infarction within 4 h of onset of symptoms |
|
| Anistreplase | acute coronary syndrome, in all type of patients | vs placebo | - | by 196% | - | - | - | - | - | - | - | - | - | - | - | - | NS | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | 2.96 [1.18 7.45] | p=0.04 | 0 | 159 | 1 | UNASEM, | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | 1.36 [0.69 2.68] | p=1.00 | 0 | 159 | 1 | UNASEM, | | reinfarction | no data | | In-hospital death | 2.96 [0.30 29.11] | p=1.00 | 0 | 159 | 1 | UNASEM, | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| UNASEM, 1992 | anistreplase IV 30 UI over 5 minutes | placebo | Patients without a previous myocardial infarction, with a typical history of unstable angina and ECG abnormalities indicative of ischemia |
|
| Anistreplase | acute myocardial infarction, in all type of patients | vs streptokinase | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| TEAM 2, 1991 | anistreplase (30 units/2-5 min) | streptokinase (1.5 million units/60 min | less than 76 years of age with electrocardiographic ST segment elevation who could be treated within 4 hours of symptom onset |
|
| Candesartan | pulmonary embolism, in all type of patients | vs alteplase | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Tebbe, 2009 | 125, 180, and 250 microg/kg bodyweight desmoteplase | 100 mg alteplase | acute massive pulmonary thromboembolism |
|
| Rt-PA | pulmonary embolism, in all type of patients | vs no fibrinolysis | NS | - | - | - | NS | NS | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NS | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | 0.75 [0.11 5.19] | p=1.00 | 0 | 137 | 2 | PAIMS 2, Goldhaber, | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 1.88 [0.43 8.24] | p=1.00 | 0 | 137 | 2 | PAIMS 2, Goldhaber, | | Major bleeding | 1.88 [0.43 8.24] | p=1.00 | 0 | 137 | 2 | PAIMS 2, Goldhaber, | | Minor bleeding | 2.20 [0.52 9.23] | p=1.00 | 0 | 36 | 1 | PAIMS 2, | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | 0.23 [0.03 1.54] | p=1.00 | 0 | 137 | 2 | PAIMS 2, Goldhaber, | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| PAIMS 2, 1992 | rt-PA 100 mg IV over 2 h and heparin | Heparin 1750 IU/hr i.v. for 7 to 10 days | patients with angiographically documented pulmonary embolism | | Goldhaber, 1993 | rt-PA 100 mg IV over 2 h then 1000 U/hr heparin,when PTT or TT was < 2 times control. Subsequent heparin dose achieved PTT = 1.5 to 2.5 times the upperlimit of normal. | heparin, initial dose 5000 U bolus followed by 1000 U/hr continuous i.v., 4 hr after the dose of heparin according to PTT. Target PTT = 1.5 to 2.5 times of normal | haemodynamically stable patients with acute pulmonary embolism |
|
| Rt-PA | pulmonary embolism, in all type of patients | vs placebo | NS | - | - | - | NS | NS | by 1036% | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NS | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | 1.62 [0.45 5.80] | p=1.00 | 0 | 327 | 3 | PIOPED, Levine, Konstantinides, | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 0.43 [0.08 2.27] | p=1.00 | 0 | 327 | 3 | PIOPED, Levine, Konstantinides, | | Major bleeding | 0.43 [0.08 2.27] | p=1.00 | 0 | 327 | 3 | PIOPED, Levine, Konstantinides, | | Minor bleeding | 11.36 [1.37 94.15] | p=0.04 | 0 | 58 | 1 | Levine, | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | 1.11 [0.30 4.20] | p=1.00 | 0 | 314 | 2 | Levine, Konstantinides, | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| PIOPED, 1990 | rt-PA 40–80 mg IV over 90 min plus heparin | placebo+heparin | patients with acute pulmonary embolism | | Levine, 1990 | rt-PA 0.6 mg/kg IV over 2 min and heparin, initial bolus of 5000 U, then 30,000 U for first 24 hr continuous infusion,only interrupted for the duration of the study drug infusion | placebo + heparin bolus of 5000 U, then 30,000 U for first 24 hr continuous infusion | patients with objectively established acute symptomatic pulmonary embolism | | Konstantinides, 2002 | 100 mg alteplase given as 10 mg bolus followed by 90 mg i.v. infusion over 2 hours then i.v. heparin 1000 U/hr adjusted to maintain APTT of 2.0 to 2.5times the upper normal limit. Oral anticoagulation was started on day 3 | placebo + i.v. heparin 1000 U/hr adjusted to maintain APTT of 2.0 to 2.5times the upper normal limit. Oral anticoagulation was started on day 3 | patients with acute pulmonary embolism and pulmonary hypertensionor right ventricular dysfunction but withoutarterial hypotension or shock |
|
| Tenecteplase | acute myocardial infarction, in all type of patients | vs accelerated t-PA | - | - | - | - | by 22% | by 22% | - | - | - | - | NS | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 0.78 [0.68 0.90] | p=0.04 | 0 | 16949 | 1 | ASSENT-2, | | Major bleeding | 0.78 [0.68 0.90] | p=0.04 | 0 | 16949 | 1 | ASSENT-2, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 1.01 [0.89 1.14] | p=1.00 | 0 | 16949 | 1 | ASSENT-2, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.07 [0.85 1.35] | p=1.00 | 0 | 16949 | 1 | ASSENT-2, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| ASSENT-2, 1999 | Tenecteplase en IV bolus (dose en fonction du poids: 30 mg si < 60 kg; 35 mg si poids entre 60 et 69.9 kg; 40 mg pour les 80-89.9 kg; 50 mg si > ou = 90 kg | Alteplase en IV, bolus de 15 mg, puis 0.75 mg/kg (sans dépasser 50 mg) en 30 min puis 0.50 mg/kg (sans dépasser 35 mg) en 60 min | patients with acute myocardial infarction of less than 6 h duration |
|
| Tenecteplase | cardiac arrest, in all type of patients | vs placebo | NS | - | - | - | - | - | - | - | NS | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NS | NS | NS | - | NS | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | 0.87 [0.63 1.20] | p=1.00 | 0 | 1085 | 2 | TROICA, TICA, | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | 0.87 [0.62 1.21] | p=1.00 | 0 | 1050 | 1 | TROICA, | | intracranial hemorrhage | 0.87 [0.62 1.21] | p=1.00 | 0 | 1050 | 1 | TROICA, | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | 0.87 [0.62 1.21] | p=1.00 | 0 | 1050 | 1 | TROICA, | | Return of spontaneous circulation | 0.87 [0.62 1.21] | p=1.00 | 0 | 1050 | 1 | TROICA, | | Failure of return of spontaneous circulation | 1.03 [0.74 1.43] | p=1.00 | 0 | 1050 | 1 | TROICA, | | Death before hospital admission | no data | | Death before hospital discharge | 1.03 [0.74 1.43] | p=1.00 | 0 | 1050 | 1 | TROICA, |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| TROICA, 2008 | tenecteplase (dose according to estimated
body weight) | placebo | adults with witnessed out-of-hospital cardiac arrest of presumed cardiac origin and with initiation of basic or advanced life support within 10 minutes after collapse | | TICA, 2004 | tenecteplase 50 mg | placebo | All victims of out of hospital cardiac arrest |
|
| Heparin | venous thrombosis, in all type of patients | vs no fibrinolysis | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NS | - | - | NS | NS | - | NS | NS | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | 5.00 [0.23 110.42] | p=1.00 | 0 | 46 | 1 | Schweizer tPA, | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | 1.25 [0.37 4.18] | p=1.00 | 0 | 44 | 1 | Schweizer tPA, | | Post-thrombotic syndrome (late) | 0.82 [0.22 3.09] | p=1.00 | 0 | 44 | 1 | Schweizer tPA, | | Mortality (late) | no data | | Leg ulceration (late) | 2.00 [0.17 23.82] | p=1.00 | 0 | 44 | 1 | Schweizer tPA, | | Stroke/intracerebral bleeding (early) | 1.00 [0.02 52.63] | p=1.00 | 0 | 46 | 1 | Schweizer tPA, | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Schweizer tPA, 1998 | tPA 20 mg IV into pedal vein over 4 hours each day for 7 days. Heparin IV given
concomitantly, with adjustment | heparin IV, adjusted for 7 days | patients with venographically confirmed DVT of leg duration < 7 days. |
|
| Streptokinase | acute myocardial infarction, in all type of patients | vs placebo | - | - | - | by 9% | by 238% | by 238% | - | - | - | - | by 18% | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | 0.91 [0.83 0.99] | p=0.04 | 0 | 13453 | 2 | ISAM, GISSI I, | | Major bleeding | 3.38 [2.26 5.04] | p=0.04 | 0 | 19296 | 3 | ISAM, ISIS-2 (SK), Western Washington Intravenous Trial, | | Major bleeding | 3.38 [2.26 5.04] | p=0.04 | 0 | 19296 | 3 | ISAM, ISIS-2 (SK), Western Washington Intravenous Trial, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.82 [0.76 0.87] | p=0.04 | 0 | 35542 | 5 | Western Washington Intravenous Trial, GISSI I, ISAM, ISIS-2 (SK), EMERAS (all delay), | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 0.91 [0.64 1.29] | p=1.00 | 0 | 17187 | 1 | ISIS-2 (SK), | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| ISAM, 1986 | 1.5 million IU of streptokinase over 1h | Placebo | patients within six hours after the onset of symptoms of myocardial infarction | | ISIS-2 (SK), 1988 | 1-hour intravenous infusion of 1.5 MU of streptokinase | Placebo | patients within 24h of the onset of suspected acute myocardial infarction | | Western Washington Intravenous Trial, 1988 | Streptokinase en IV, 1.5 M UI en 60 min après injection de benadryl 50 mg en IV et hydrocortisone 100 mg en IV; héparine en IV 1000 UI/h 2h après la streptokinase puis warfarine pendant au moins 3 mois | Traitement standard, avec ou sans anticoagulant (décidé par le médecin) | Hommes et femmes, < ou = 75 ans | | GISSI I, 1986 | Streptokinase 1.5 MU en perfusion IV en 1 heure | usual care | patients within 12 h after the onset of symptoms and with no contraindications to SK | | EMERAS (all delay), 1993 | streptokinase 1.5 MU | placebo | patients entering hospital up to 24 h after the onset of suspected acute myocardial infarction | | ISIS 2 pilot, 1987 | streptokinase 1.5 MU | placebo | patients with suspected acute myocardial infarction | | EMERAS (7-12h), 1993 | intravenous streptokinase 1.5 MU | placebo | patients presenting 7-12 h from symptom onset |
|
| Streptokinase | acute myocardial infarction, in all type of patients | vs streptokinase | - | - | - | - | - | - | - | - | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.96 [0.87 1.05] | p=1.00 | 0 | 30625 | 1 | GUSTO tPA-SK Hiv, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| GUSTO tPA-SK Hiv, 1993 | tPA en IV 1 mg/kg, sans dépasser 90 mg, dont 10 % en bolus + streptokinase 1 MU en 60 min + héparine en IV (5000 U en bolus, 1000 U/h (de préférence 1200 U/h si > 80 kg), poursuivi au moins 48 h) | Streptokinase 1.5 MU en 60 min + héparine SC (12500 U 2 fois/j commencée 4h après thrombolytique) combiné à streptokinase (1.5 MU en 60 min) + héparine en IV (5000 U en bolus, puis 1000 U/h (1200 U/h si > 80 kg) poursuivi au moins 48 h) | Hommes et femmes |
|
| Streptokinase | pulmonary embolism, in all type of patients | vs no fibrinolysis | NS | - | - | - | NS | NS | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | 0.41 [0.05 3.06] | p=1.00 | 0 | 55 | 2 | Tibbutt, Ly, | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 1.48 [0.30 7.33] | p=1.00 | 0 | 55 | 2 | Tibbutt, Ly, | | Major bleeding | 1.48 [0.30 7.33] | p=1.00 | 0 | 55 | 2 | Tibbutt, Ly, | | Minor bleeding | 0.68 [0.18 2.61] | p=1.00 | 0 | 55 | 2 | Tibbutt, Ly, | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Tibbutt, 1974 | intrapulmonary SK 600,000-U bolus, then 100,000 U/h for 72 h and intrapulmonary heparin | 5000U heparin plus 100mg hydrocortisone infused over 30 mins through pulmonary artery catheter. Followed by 2500 U for 72 hr | life-threatening pulmonary embolism | | Ly, 1978 | streptokinase 250,000-U bolus, then 100,000 U/h for 72 h and heparin | Heparin 15,000 IU initial dose i.v. followed by 30,000 IU/day continuous i.v., adjusted by TT | patients with major pulmonary embolism verified by angiography | | Jerjes-Sanchez, 1995 | streptokinase 1,500,000 U IV over 1 h and heparin | heparin alone | high clinical suspicion for massive pulmonary embolism |
|
| Streptokinase | venous thrombosis, in all type of patients | vs no fibrinolysis | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | by 203% | NS | NS | NS | by 1115% | NS | by 277% | NS | NS | NS | NS | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | 3.03 [1.10 8.31] | p=0.04 | 0 | 129 | 4 | Common, Elsharawy, Schulman, Kakkar (streptokinase), | | Mortality (early) | 1.04 [0.28 3.85] | p=1.00 | 0 | 182 | 5 | Arneson, Common, Elsharawy, Schulman, Kakkar (streptokinase), | | Pulmonary embolism (early) | 0.60 [0.12 3.10] | p=1.00 | 0 | 132 | 4 | Arneson, Elsharawy, Schulman, Kakkar (streptokinase), | | Bleeding (early) | 1.52 [0.67 3.45] | p=1.00 | 0 | 181 | 5 | Arneson, Common, Elsharawy, Schulman, Kakkar (streptokinase), | | Any improvement in venous patency (early) | 12.15 [7.16 20.61] | p=0.04 | 0 | 141 | 4 | Arneson, Common, Elsharawy, Kakkar (streptokinase), | | Normal venous function (late) | 2.09 [0.68 6.45] | p=1.00 | 0 | 66 | 2 | Elsharawy, Schulman, | | Complete clot lysis (late) | 3.77 [1.39 10.27] | p=0.04 | 0 | 123 | 4 | Arneson, Common, Elsharawy, Schulman, | | Post-thrombotic syndrome (late) | 0.47 [0.11 2.01] | p=1.00 | 0 | 35 | 1 | Arneson, | | Mortality (late) | 1.33 [0.26 6.85] | p=1.00 | 0 | 42 | 1 | Arneson, | | Leg ulceration (late) | 0.32 [0.03 3.56] | p=1.00 | 0 | 71 | 2 | Arneson, Schulman, | | Stroke/intracerebral bleeding (early) | 1.27 [0.27 6.06] | p=1.00 | 0 | 215 | 6 | Arneson, Common, Elsharawy, Schulman, Tsapogas, Kakkar (streptokinase), | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Arneson, 1978 | streptokinase 250,000 U loading IV, then 100,000 IU/hour IV 72-96 hours
| heparin 15,000 IU IV bolus, 30,000 IU infusion IV 72-90 hours¢ßl | inpatients with venographically confirmed DVT extending proximally beyond the calf <5 days duration? | | Common, 1976 | hydrocortisone 100 mg IV then streptokinase IV 250,000 U over 30 minutes, then 100,000
U/hour titrated for 72 hours. Followed by IV heparin titrated over 7 days | IV heparin 150 U/kg loading dose then titrated for 10 days | patients with venographically confirmed DVT duration < 14 days | | Elsharawy, 2002 | catheter-directed thrombolysis with streptokinase using popliteal approach. | heparin IV bolus 5000 U, then adjusted continuous infusion. Warfarin begun the same evening | iliofemoral venous thrombosis confirmed by duplex or venography duration < 10 daysicatio | | Schulman, 1986 | streptokinase 50,000 IU IV over 15 minutes then 100,000 IU over 12 hours for up to 7 days,
titrated. Given with 5000 IU heparin IV over 12 hours. Warfarin begun after streptokinase ended | heparin 5000 IUIVbolus then 30,000 IUper day, titrated for 7 days.Warfarin begun simultaneously | patients with venographically confirmed calf vein thrombosis of duration < 7 days. | | Tsapogas, 1973 | titrated dose of streptokinase IV into ankle veinmage/pj | heparin IV into affected limbitm | patients with DVT confirmed by venogram of duration < 5 days. | | Kakkar (streptokinase), 1969 | streptokinase 500,000 U IV over 30 minutes, 900,000 U every 6 hours for 5 days | heparin 10,000 U over 5 minutes, then 10,000 to 15,000 U every 6 hours for 5 dayslicatio | patients with venographically confirmed DVT of leg of duration < 4 days | | Schweizer (systemic SK), 2000 | Systemic streptokinase 3,000,000 U/day over 6 hours in conjunction with heparin for up to 7 days. Premedication: hydrocortisone 100 mg, ranitidine 50 mg, clemastine 2 mg | heparin IV, adjusted | patients with thrombosis of popliteal or more proximal veins confirmed by venogram at more than one level of duration < 9 days |
|
| T-pa | acute coronary syndrome, in all type of patients | vs placebo | NS | NS | - | - | - | - | - | - | - | - | - | - | - | - | NS | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | 1.00 [0.06 16.65] | p=1.00 | 0 | 70 | 1 | Freeman, | | Bleeding | 2.83 [0.96 8.32] | p=1.00 | 0 | 103 | 2 | Williams, van der Brand, | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | 1.14 [0.44 2.95] | p=1.00 | 0 | 237 | 5 | Nicklas, Williams, Freeman, van der Brand, Ardissino, | | reinfarction | no data | | In-hospital death | 1.51 [0.36 6.38] | p=1.00 | 0 | 217 | 5 | Nicklas, Williams, Freeman, Ardissino, Topol, | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Nicklas, 1989 | rt-PA, 150 mg/8 h | placebo | patients with rest angina, angiographically documented coronary artery disease and pacing-induced ischemia | | Gold, 1987 | intravenous recombinant human tissue-type plasminogen activator (rt-PA). | placebo | chest pain at rest with transient ST segment deviation of at least 1 mm | | Williams, 1990 | tissue-type plasminogen activator (rt-PA) (0.75 mg/kg over 1 hour or (0.75 mg/kg over 1 hour; total dose, 100 mg over 6 hours) | placebo | rest angina and angiographic evidence of coronary stenosis | | Freeman, 1992 | tissue-type plasminogen activator (t-PA) (0.49 MU/kg for 1 hour followed by 0.07 MU/kg per hour for 9 hours) | placebo | patients with unstable angina | | van der Brand, 1991 | alteplase 100 mg in 3 h | placebo | patients with angina at rest, despite bedrest and medical treatment | | charbonnier, 1992 | rt-PA 100 mg/90 minutes (10 mg bolus + 90 mg/90 minutes | placebo | unstable angina pectoris | | Ardissino, 1990 | recombinant tissue-type plasminogen activator (rt-PA) followed by heparin | heparin alone | unstable angina refractory to conventional medical treatment | | TIMI 3B, 1995 | tissue-type plasminogen activator (t-PA) | placebo | patients with unstable angina and non-Q wave myocardial infarction | | Topol, 1988 | intravenous tissue plasminogen activator (t-PA) | placebo | patients with angina at rest and provocable ischemia (pacing induced) | | TIMI 3A, 1993 | 90-minute front-loaded infusion of t-PA (0.8 mg/kg i.v.; maximum, 80 mg) | placebo | patients with unstable angina or non-Q wave myocardial infarction |
|
| T-pa | acute myocardial infarction, in all type of patients | vs placebo | - | - | - | by 20% | by 136% | by 136% | - | - | - | - | by 15% | - | - | NS | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | 0.80 [0.68 0.95] | p=0.04 | 0 | 5208 | 2 | ASSET, TAMI 6, | | Major bleeding | 2.36 [1.29 4.31] | p=0.04 | 0 | 5208 | 2 | ASSET, TAMI 6, | | Major bleeding | 2.36 [1.29 4.31] | p=0.04 | 0 | 5208 | 2 | ASSET, TAMI 6, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.85 [0.75 0.95] | p=0.04 | 0 | 10919 | 3 | ASSET, LATE, TAMI 6, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.11 [0.65 1.91] | p=1.00 | 0 | 5011 | 1 | ASSET, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | 0.63 [0.15 2.72] | p=1.00 | 0 | 197 | 1 | TAMI 6, | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| ASSET, 1988 | rt-PA 100 mg | Placebo | patient with suspected acute myocardial infarction | | LATE, 1993 | intravenous alteplase (100 mg over 3 h) | placebo | patients with symptoms and electrocardiographic criteria consistent with AMI between 6 and 24 h from symptom onset | | TAMI 6, 1992 | tissue-type plasminogen activator 100 mg over 2 hours | placebo | patients with 6 to 24 hours of symptoms and ECG ST elevation |
|
| T-pa | acute myocardial infarction, in all type of patients | vs accelerated t-PA | - | - | - | - | NS | NS | - | - | - | - | NS | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 1.09 [0.61 1.95] | p=1.00 | 0 | 7169 | 1 | COBALT, | | Major bleeding | 1.09 [0.61 1.95] | p=1.00 | 0 | 7169 | 1 | COBALT, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 1.06 [0.89 1.26] | p=1.00 | 0 | 7169 | 1 | COBALT, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.25 [0.88 1.79] | p=1.00 | 0 | 7169 | 1 | COBALT, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| COBALT, 1997 | of 50 mg of alteplase over a period of 1 to 3 minutes followed 30 minutes later by a second bolus of 50 mg (or 40 mg for patients who weighed less than 60 kg). | weight-adjusted, accelerated infusion of 100 mg of alteplase | patients with acute myocardial infarction |
|
| T-pa | acute myocardial infarction, in all type of patients | vs APSAC | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| TAPS, 1992 | front-loaded administration of rt-PA | APSAC | patients with acute myocardial infarction. | | TIMI 4, 1994 | front-loaded rt-PA | APSAC | patients with acute myocardial infarction |
|
| T-pa | acute myocardial infarction, in all type of patients | vs streptokinase | - | - | - | NS | by 18% | by 18% | - | - | - | - | NS | - | - | NS | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | 1.02 [0.96 1.07] | p=1.00 | 0 | 48294 | 2 | International Study Group, ISIS III (SK/tPA), | | Major bleeding | 0.82 [0.69 0.97] | p=0.04 | 0 | 61910 | 9 | GISSI II, International Study Group, ISIS III (SK/tPA), Centre Illinois, Cherng, ECSG, PAIMS, TIMI-1, White, | | Major bleeding | 0.82 [0.69 0.97] | p=0.04 | 0 | 61910 | 9 | GISSI II, International Study Group, ISIS III (SK/tPA), Centre Illinois, Cherng, ECSG, PAIMS, TIMI-1, White, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.99 [0.94 1.03] | p=1.00 | 0 | 92583 | 10 | GISSI II, International Study Group, ISIS III (SK/tPA), GUSTO tPA Hiv, Centre Illinois, Cherng, ECSG, PAIMS, TIMI-1, White, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.03 [0.88 1.20] | p=1.00 | 0 | 60797 | 4 | GISSI II, International Study Group, ISIS III (SK/tPA), Cherng, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | 0.46 [0.11 1.86] | p=1.00 | 0 | 122 | 1 | Cherng, | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| GUSTO tPA Hiv, 1993 | tPA accéléré (15 mg en bolus, puis 0.75 mg/kg en 30 min sans dépasser 50 mg puis 0.5 mg/kg en 60 min sans dépasser 35 mg) + héparine en IV (5000 U en bolus, 1000 U/h (de préférence 1200 U/h si > 80 kg), poursuivi au moins 48 h) | Streptokinase 1.5 MU en 60 min + héparine SC (12500 U 2 fois/j commencée 4h après thrombolytique) combiné à streptokinase (1.5 MU en 60 min) + héparine en IV (5000 U en bolus, puis 1000 U/h (1200 U/h si > 80 kg) poursuivi au moins 48 h) | Hommes et femmes | | GISSI II, 1990 | alteplase 100 mg infused intravenously over 3 h | streptokinase 1.5 MU infused intravenously over 30-60 min | patients with acute myocardial infarction within 6 h from onset of symptoms | | International Study Group, 1990 | tPA 100 mg en IV en 3 h (10 mg en bolus, puis 50 mg en 1 h, puis 20 mg/h pendant 2 h) | Streptokinase 1.5 MU en IV de 30 à 60 min | patients with suspected acute myocardial infarction of less than 6 h duration | | ISIS III (SK/tPA), 1992 | Streptokinase 1.5 MU en IV dune heure | tPA 0.04 MU/kg en IV en bolus d1 min, puis 0.36 MU/kg en 1 h, puis 0.067 MU/kg/h pendant 3 h | Hommes et femmes | | Centre Illinois, 1993 | t-PA 10 mg bolus, followed by 50 mg in the first hour, and 20 mg/hour for the next 2 hours | SK 375 000 IU bolus, followed by 1 125 000 IU/1 hage/pj | patients with AMI within 3h from onset of chest pain | | Cherng, 1992 | 100 mg of rTPA over 3 hours (with early heparinization) | 1,500,000 units of streptokinase over 1 hour | patients with acute myocardial infarction | | ECSG, 1985 | 0.75 mg rt-PA/kg over 90 min | 1 500 000 IU streptokinase over 60 min | patients with acute myocardial infarction of less than 6 h duration | | PAIMS, 1989 | intravenous cumulative dose of 100 mg rt-PA | .5 million units streptokinase | patients with acute myocardial infarction less than 3 h old | | TIMI-1, 1987 | rt-PA, 40, 20, and 20 mg in successive hours | SK 1.5 million units over 1 hr | patients with evolving acute myocardial infarction within 7 hr of the onset of symptoms | | White, 1989 | rt-PA 100 mg over three hours | streptokinase 1.5 million units over 30 minutes | patients with AMI |
|
| T-pa | acute myocardial infarction, in all type of patients | vs t-PA | - | - | - | - | - | - | - | - | - | - | NS | - | - | NS | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 1.65 [0.63 4.33] | p=1.00 | 0 | 281 | 1 | RAAMI, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 0.32 [0.03 3.13] | p=1.00 | 0 | 281 | 1 | RAAMI, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | 0.11 [0.01 2.05] | p=1.00 | 0 | 216 | 1 | KAMIT, | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| KAMIT, 1991 | half-dose (50 mg) t-PA with streptokinase (1.5 MU) during 1 hour | t-PA (100 mg) during 3 hours | patients within 6 hours of myocardial infarction | | RAAMI, 1992 | 100 mg of rt-PA accelerated 90-min regimen (15-mg bolus followed by 50 mg over 30 min, then 35 mg over 60 min) | 100 mg of rt-PA standard 3-h infusion regimen (an initial 10-mg bolus followed by 50 mg for the 1st h, then 20 mg/h for 2 h | patients with acute myocardial infarction within 6h from onset of chest pain |
|
| T-pa | acute myocardial infarction, in all type of patients | vs urokinase | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| TAMI 5 (t-PA vs uroK), 1991 | accelerated t-PA 100mg over 3h | urokinase IV bolus 1.5 MU followed by 1.5 MU over 90min | patient with acute myocardial infarction |
|
| T-pa | acute myocardial infarction, in >6h from onset of symptoms | vs placebo | - | - | - | - | - | - | - | - | - | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.91 [0.78 1.05] | p=1.00 | 0 | 5711 | 1 | LATE, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| LATE, 1993 | intravenous alteplase (100 mg over 3 h) | placebo | patients with symptoms and electrocardiographic criteria consistent with AMI between 6 and 24 h from symptom onset |
|
| T-pa | cardiac arrest, in all type of patients | vs placebo | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NS | NS | NS | - | NS | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | NaN [NaN NaN] | p=1.00 | 0 | 233 | 1 | Abu-Laban, | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | 2.97 [0.12 73.78] | p=1.00 | 0 | 233 | 1 | Abu-Laban, | | Return of spontaneous circulation | 0.92 [0.50 1.70] | p=1.00 | 0 | 233 | 1 | Abu-Laban, | | Failure of return of spontaneous circulation | 1.02 [0.55 1.90] | p=1.00 | 0 | 233 | 1 | Abu-Laban, | | Death before hospital admission | no data | | Death before hospital discharge | NaN [NaN NaN] | p=1.00 | 0 | 233 | 1 | Abu-Laban, |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Abu-Laban, 2002 | t-PA 100mg over a 15-minute period | placebo | Victims of cardiac arrest with pulseless electrical activity for more than one minute and had had no palpable pulse for more than three minutes during resuscitative efforts and at the time of the initiation of the study drug |
|
| T-pa | venous thrombosis, in all type of patients | vs no fibrinolysis | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NS | by 174% | - | - | - | - | - | NS | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | 2.12 [0.48 9.42] | p=1.00 | 0 | 148 | 2 | Goldhaber (tPA alone), Turpie, | | Any improvement in venous patency (early) | 2.74 [1.20 6.27] | p=0.04 | 0 | 147 | 2 | Goldhaber (tPA alone), Turpie, | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | 1.02 [0.02 52.88] | p=1.00 | 0 | 83 | 1 | Turpie, | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Goldhaber (tPA alone), 1990 | tPA alone 0.05 mg/kg/hour IV over 24 hours, then heparin100U/kg bolus, then 1000 U/hour, adjusted | heparin alone 100 U/kg bolus, then 1000 U/hour | venographically documented DVT, in popliteal ormore proximal veins < 14 days duration | | Schweizer (local tPA), 2000 | local tPA 20 mg/day, over 4 hours via pedal vein for 4-7 days. IV heparin given
simultaneously at 1000 IU/hour, adjusted | heparin IV, adjusted | patients with thrombosis of popliteal or more proximal veins confirmed by venogram at more than one level of duration < 9 days | | Turpie, 1990 | tPA + IV heparin | 5000 U bolus then 30,000 U/24 hours, adjusted for 7-10 days (+placebo) | patients with venographically confirmed proximal DVT of lower limb of duration < 7 days | | Verhaeghe (high dose), 1989 | IV tPA 100 mg on day 1, 50 mg tPA on day 2. 10% of dose given as bolus; heparin 5000 U IV bolus then continuous infusion of 1000 U per hour for up to 72 hours | heparin 5000 U IV bolus then continuous infusion of 1000 U per hour for up to 72 hours (+placebo) | hospitalised patients with DVT of popliteal or more proximal veins of the lower leg, confirmed by venography of duration < 10 days. | | Goldhaber (tPA+heparin), 1990 | tPA 0.05 mg/kg/hour IV over 24 hours and heparin 100U/kg bolus, then 1000 U/hour, adjusted | heparin alone 100 U/kg bolus, then 1000 U/hour. | patients with venographically documented DVT, in popliteal ormore proximal veins < 14 days duration | | Verhaeghe (low dose), 1989 | IV tPA 50 mg on day 1, repeated on day 2. 10% of dose given as bolus; heparin 5000 U IV bolus then continuous infusion of 1000 U per hour for up to 72 hours | heparin 5000 U IV bolus then continuous infusion of 1000 U per hour for up to 72 hours (+placebo) | hospitalised patients with DVT of popliteal or more proximal veins of the lower leg, confirmed by venography of duration < 10 days. |
|
| Urokinase | acute myocardial infarction, in all type of patients | vs control | - | - | - | - | NS | NS | - | - | - | - | NS | - | - | NS | - | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 1.19 [0.32 4.44] | p=1.00 | 0 | 2201 | 1 | USIM, | | Major bleeding | 1.19 [0.32 4.44] | p=1.00 | 0 | 2201 | 1 | USIM, | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | 0.97 [0.71 1.31] | p=1.00 | 0 | 2196 | 1 | USIM, | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | 1.90 [0.35 10.41] | p=1.00 | 0 | 2201 | 1 | USIM, | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | 1.30 [0.81 2.10] | p=1.00 | 0 | 2201 | 1 | USIM, | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| USIM, 1991 | urokinase bolus dose of 1 million U repeated after 60 minutes plus heparin | control (heparin alone) | patients with acute myocardial infarction within 4 hours of the onset of pain |
|
| Urokinase | pulmonary embolism, in all type of patients | vs no fibrinolysis | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Marini, 1988 | urokinase 800,000 U/d IV for 72 h, UK 3,300,000 U IV for 12 h and heparin | heparin | patients with pulmonary embolism |
|
| Urokinase | pulmonary embolism, in all type of patients | vs placebo | NS | - | - | - | NS | NS | NS | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NS | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | 0.82 [0.26 2.54] | p=1.00 | 0 | 160 | 1 | UPET, | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | 1.90 [0.85 4.25] | p=1.00 | 0 | 160 | 1 | UPET, | | Major bleeding | 1.90 [0.85 4.25] | p=1.00 | 0 | 160 | 1 | UPET, | | Minor bleeding | 1.43 [0.60 3.40] | p=1.00 | 0 | 160 | 1 | UPET, | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | no data | | Pulmonary embolism (early) | no data | | Bleeding (early) | no data | | Any improvement in venous patency (early) | no data | | Normal venous function (late) | no data | | Complete clot lysis (late) | no data | | Post-thrombotic syndrome (late) | no data | | Mortality (late) | no data | | Leg ulceration (late) | no data | | Stroke/intracerebral bleeding (early) | no data | | recurrence of pulmonary embolism | 0.76 [0.33 1.75] | p=1.00 | 0 | 160 | 1 | UPET, | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| UPET, 1973 | urokinase 2,000-U/lb bolus, then 2,000 U/lb per h IV for 12 h and heparin | placebo + Heparin (a loading dose of 75 U/pound, then 10 U/pound/hr for 12 hr infusion, then heparin for a minimum of 5 days, followed by heparin or warfarin therapy for a total of 14 days) | patients with pulmonary embolism |
|
| Urokinase | venous thrombosis, in all type of patients | vs no fibrinolysis | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | NS | - | NS | NS | - | NS | NS | - | NS | NS | - | - | - | - | - | - | | Endpoint | TE [95% CI] | p val | I2 | n | k | trials |
|---|
| All cause death | no data | | Bleeding | no data | | Cardiovascular death | no data | | Long term death | no data | | Major bleeding | no data | | Major bleeding | no data | | Minor bleeding | no data | | Haemmorhagic stroke | no data | | ischemic stroke | no data | | intracranial hemorrhage | no data | | short term death | no data | | Deaths or MI | no data | | In hospital death or MI | no data | | stroke (fatal and non fatal) | no data | | myocardial infarction (fatal and non fatal) | no data | | reinfarction | no data | | In-hospital death | no data | | Complete clot lysis (early) | no data | | Mortality (early) | 1.24 [0.13 12.02] | p=1.00 | 0 | 65 | 2 | Kiil, Schweizer (urokinase), | | Pulmonary embolism (early) | no data | | Bleeding (early) | 0.61 [0.09 3.97] | p=1.00 | 0 | 20 | 1 | Kiil, | | Any improvement in venous patency (early) | 0.73 [0.04 13.69] | p=1.00 | 0 | 19 | 1 | Kiil, | | Normal venous function (late) | no data | | Complete clot lysis (late) | 2.13 [0.57 7.97] | p=1.00 | 0 | 44 | 1 | Schweizer (urokinase), | | Post-thrombotic syndrome (late) | 0.65 [0.18 2.38] | p=1.00 | 0 | 44 | 1 | Schweizer (urokinase), | | Mortality (late) | no data | | Leg ulceration (late) | 1.00 [0.06 17.07] | p=1.00 | 0 | 44 | 1 | Schweizer (urokinase), | | Stroke/intracerebral bleeding (early) | 0.86 [0.05 14.43] | p=1.00 | 0 | 65 | 2 | Kiil, Schweizer (urokinase), | | recurrence of pulmonary embolism | no data | | Survival to hospital discharge | no data | | Return of spontaneous circulation | no data | | Failure of return of spontaneous circulation | no data | | Death before hospital admission | no data | | Death before hospital discharge | no data |
TE: treatment effect; CI: confidence interval; k: nulmber of trials; n: total number of patients | Trial | Studied treatment | Control | Patients |
|---|
| Kiil, 1981 | urokinase 200,000 U IV over 24 hours. After 18 hours, heparin loading dose of 15,000 units
then 40,000 U/day for 5 days (+placebo) | heparin 40,000 U/day IV for 6 days (+placebo) | patients with venographically confirmed DVT duration < 72 hours | | Schweizer (urokinase), 1998 | Urokinase 100,000 IU/hr IV into pedal vein continuously for 7 days. Heparin IV for 7 days. Plasminogen
monitored. Warfarin from day 7 to 12 monthsd=132 | heparin IV, adjusted for 7 days | patients with venographically confirmed DVT of leg duration < 7 days | | Schweizer (local urokinase), 2000 | Local urokinase 100,000 IU/day infused continuously. Fibrinogen and plasminogen monitored. Heparin IV given concomitantly | heparin IV, adjusted | patients with thrombosis of popliteal or more proximal veins confirmed by venogram at more than one level of duration < 9 days | | Schweizer (systemic urokinase), 2000 | Systemic urokinase 5,000,000 IU/day over 4 hours for up to 7 days. IV heparin given concomitantly | heparin IV, adjusted | patients with thrombosis of popliteal or more proximal veins confirmed by venogram at more than one level of duration < 9 days |
|
