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GUSTO II trial

Authoring team

The GUSTO II study investigated the role of the thrombin-specific inhibitor hirudin in the treatment of myocardial infarction.

  • GUSTO-IIa - stopped early because of intracerebral haemorrhages (1)
    • re-initiated at lower dose of hirudin (see GUSTO-IIb)
    • Hirudin (vs. heparin)
      • greater incidence of stroke
      • even greater difference in those treated with thrombolysis
      • indication that APTT useful for predicting stroke risk in thrombolysis patients

  • GUSTO-IIb (Lower dose of Hirudin vs. GUSTO-IIa) (2)
    • Hirudin (vs. Heparin)
      • significantly reduced risk of death or MI at 24hr
      • no significant difference at 30 days

Reference:

  • Circulation. 1994 Oct;90(4):1631-7.
  • N Engl J Med. 1996 Sep 12;335(11):775-82.

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