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Recombinant hirudin (lepirudin) for the improvement of thrombolysis with streptokinase in patients with acute myocardial infarction

Results of the HIT-4 trial

Karl-Ludwig Neuhaus, MD^a, G. Peter Molhoek, MD, Uwe Zeymer, MD^a, Ulrich Tebbe, MD, Karl Wegscheider, PhD, Rolf Schröder, MD, FACC, Anne Camez, MD^||, G. Jan Laarman, MD^¶, Gilles M. Grollier, MD^#, Dirk J. A. Lok, MD^**, Holger Kuckuck, MD, Peter Lazarus, MD for the HIT-4 Investigators

^a Städtische Kliniken, Kassel, Germany
Medisch Spectrum Enschede, Twente, The Netherlands
Klinikum Lippe-Detmold, Detmold, Germany
Universitätsklinikum Benjamin Franklin, Berlin, Germany
^|| Behringwerke AG, Marburg, Germany
^¶ Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
^# Centre Hospitalier Universitaire, Caen, France
^** Deventer Ziekenhuis, Deventer, The Netherlands
Wenckebach Krankenhaus, Berlin, Germany
Klinikum Schwerin, Schwerin, Germany

View larger version (33K): [in a new window]   Figure 1 Comparison of the 90-min patency rates of the infarct-related artery in patients treated with streptokinase and lepirudin or heparin. Solid box, heparin (n = 209); striped box, lepirudin (n = 209).

View larger version (20K): [in a new window]   Figure 2 Cumulative rate of reinfarctions during the five days of study treatment and until day 30. After five days the difference between the lepirudin group and heparin group was statistically significant (p = 0.048).