ISIS-2
Second International Study of Infarct Survival
Patient / Population Intervention / Exposure Comparison Outcome
In 17,187 patients with suspected acute myocardial infarction, aspirin plus intravenous streptokinase reduced 5-week vascular mortality compared with placebo.
N
17,187
Design
2×2 factorial RCT
Endpoint
Vascular mortality at 5 weeks
Relevance
1
ResultMortality 8.0 % (combination) vs 13.2 % (placebo). Aspirin and streptokinase each independent.
ISIS-2 Collaborative Group. Lancet. 1988;332(8607):349-360. 10.1016/S0140-6736(88)92833-4
Discussion & critique
Predates primary PCI; defined the role of aspirin in MI and is the reason every chest-pain patient gets chewable aspirin. Streptokinase has been superseded by fibrin-specific lytics and primary PCI, but the aspirin signal still anchors modern ACS care.