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GISSI
About the Trial
The first Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico trial randomized more than 11,000 patients with acute myocardial infarction in Italian coronary care units to intravenous streptokinase or usual care. Hospital mortality at 21 days fell from 13.0 to 10.7 percent, a relative reduction of about 18 percent, and the benefit was largest in patients treated within the first hour of symptoms, in whom deaths were nearly halved. Published in the Lancet in 1986, GISSI established thrombolysis as standard care for heart attack and made time to treatment a central concern of cardiology. It also showed that large, simple trials across a national network were possible.
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