Late Assessment of Thrombolytic

LATE Study Group. Late Assessment of Thrombolytic Efficacy (LATE) study with alteplase 6-24 hours after onset of acute myocardial infarction. Lancet 1993 342 759-766. 

Of the nine trials included in the FTT meta-analysis. Late Assessment of Thrombolytic Efficacy (LATE) and Estudio Multicentrico Estreptoquinasa Republicas de America del Sur (EMERAS) enrolled only patients who presented >6 hours after the onset of chest pain (8,9). Both of these studies demonstrated minimal benefit from fibrinolytic therapy as compared to the impressive reductions seen in GISSI and ISIS-2 (8.9% mortality in the t-PA group vs. 10.3% mortality in the control group in LATE and no benefit of streptokinase over control in patients presenting >12 hours after symptom onset in EMERAS). The inclusion of these two trials diluted the effects of fibrinolytic therapy in the FTT analysis. Furthermore, in the prematurely terminated APSAC Intervention Mortality Study (AIMS), only 3 of the total 502 patients were >70 years of age, raising concerns about the ability of the FTT to extrapolate these results to elderly patients (10). 

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