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All randomized patients(156 in streptokinase group and 154 in the placebo group)were evaluated at six months.The incidence of the primary efficacy outcome was similar in the two groups(124 patients in the streptokinase group and 126 in the placebo group died or had a Rankin score>3).However, the mortality rate at 10 days was significantly higher in the streptokinase group than in the placebo group(34.0 percent vs.18.2 percent,P=0.002).The higher rate in the streptokinase group was mainly due to the hemorrhagic transformation of ischemic cerebral infarcts.At six months,more deaths had occurred in the streptokinase group than in the placebo group(73 vs.59,P=0.06).In patients with acute ischemic stroke, treatment with streptokinase resulted in an increase in mortality.The routine use of streptokinase cannot be recommended in acute ischemic stroke. |
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