LATE assessment of thrombolytic efficacy with alteplase (rt‐PA) six‐24 hours after onset of acute myocardial infarction

Abstract

Conflicting results on the benefit of thrombolytic therapy administered six to 24 hours after the onset of myocardial infarction (MI) led to the LATE trial. Five thousand seven hundred and eleven patients were treated with recombinant tissue plasminogen activator (t-PA) or placebo, treatment was begun between six and 24 hours after the onset of infarction. For patients treated within 12 hours, there was a relative reduction in 35 day mortality of 25%, but no benefit for those treated at 12 to 24 hours. The benefits were confined to those whose treatment was begun within three hours of admission to hospital. These results widen the window for effective treatment from six to 12 hours after the onset of infarction, but emphasise the need for expeditious treatment when the diagnosis of MI is suspected.