Australian and New Zealand journal of medicine vol:23 issue:6 pages:732-4; discussion 735-6
The mortality results for the four arms of the GUSTO trial are presented. The 30 day mortality results were as follows: streptokinase (SK) and subcutaneous heparin (n = 9796), 7.2%, SK and intravenous heparin (n = 10,377) 7.4%, accelerated tissue plasminogen activator (t-PA) and intravenous heparin (n = 10,344) 6.3%, and combined SK and t-PA (n = 10,328) 7.9%. This is a relative risk reduction of 14% for the accelerated t-PA regimen compared with the two SK regimens equivalent to an absolute risk reduction of ten lives saved per 1000 patients treated. Predefined subgroups who showed a greater benefit with t-PA versus SK were patients under the age of 75, anterior infarct location and those treated within four hours of onset of symptoms.