The efficacy of intracoronary urokinase and streptokinase were compared in 80 patients with acute myocardial infarction in a prospective, randomized, double-blind study. Urokinase was infused into the occluded coronary artery at 6000 U/min, and streptokinase was infused at 2000 U/min. 756 MethodsThis was a randomized, double-blind, parallel study of the efficacy of intracoronary urokinase (Abbokinase; Abbott Pharmaceuticals) and streptokinase (Streptase; Hoechst-Roussel Pharmaceuticals, Inc.) in treating patients with acute myocardial infarction.Patients were eligible for inclusion in the study under the following conditions: (1) typical symptoms of myocardial infarction occurred less than 12 hr before infusion, (2) electrocardiogram showed short-term changes of myocardial infarction, (3) no specific contraindication to thrombolytic therapy existed, and (4) angiographic demonstration of a completely occluded vessel related to the infarct. After informed consent was obtained, the hospital pharmacy randomized the patient to receive either urokinase or streptokinase. Unlabeled thrombolytic solution, containing either streptokinase at a concentration of 500 IU/ml or urokinase at a concentration of 1500 U/ml, was supplied by the pharmacy. All medical personnel and the clinical investigators outside the pharmacy were blinded as to the thrombolytic drug used. Baseline coagulation studies before catheterization included measurements of serum fibrinogen, fibrin split products, thrombin time, prothrombin time, partial thromboplastin time, and plasminogen levels. In the catheterization laboratory, left ventricular and coronary angiography were performed. Heparin was given without knowledge of the treatment group in bolus doses ranging from 2500 U to 10,000 U. The thrombolytic solution was then infused into the occluded infarct-related vessel at a rate of 4 ml/min (

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