CHAPTER 20 ASPIRIN IN ACUTE MI: THE ISIS-2 TRIAL

Randomized Trial of Intravenous Streptokinase, Oral Aspirin, Both, or Neither Among 17,187 Cases of Suspected Acute Myocardial Infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group

Lancet. 1988;332(8607):349–360

BACKGROUND

At the time of this study, work had been done showing that fibrinolysis reduced mortality by about 25% in the acute setting and that there was a benefit to aspirin in those with a history of previous MI, but those studies lacked power to be definitive. There was a need to assess whether aspirin could help reduce reinfarction following fibrinolytic therapy given that this was a cause of acute MI mortality and morbidity.

OBJECTIVE

To assess the separate and combined effects of IV streptokinase and oral aspirin in patients with acute MI.

METHODS

Randomized controlled trial at 417 hospitals in 16 countries.

Patients

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