The ISIS-1 to ISIS-4 series of trials randomised ~140,000 patients worldwide between 1985 and 1993. These trials were designed to reliably assess the effects of widely usable treatments on survival following a heart attack.
ISIS-1
A randomised trial of intravenous atenolol among 16,027 cases of suspected acute myocardial infarction. Patients were randomised between mid 1981 and January 1985. Overall vascular mortality was significantly lower in the atenolol group at one year. Read the results.
ISIS-2
A randomised trial of intravenous streptokinase, oral aspirin, both or neither among 17,187 cases of suspected acute myocardial infarction. Patients were randomised between March 1985 and December 1987. ISIS-2 showed unequivocally that, in suitable patients, fibrinolytic therapy (used to dissolve blood clots) reduces early mortality. ISIS-2 also showed that the benefits of early treatment with aspirin were largely independent of, and additive to, those of fibrinolytic therapy. The trial's findings transformed clinical practice worldwide. Read the results.
ISIS-3
A randomised comparison of streptokinase versus tissue plasminogen activator vs anistreplase and of aspirin plus heparin vs aspirin alone among 41,299 cases of suspected acute myocardial infarction. Patients were randomised between September 1989 and January 1991. Read the results.
ISIS Study of Possible Causes of Heart Attacks
A case-control study added to the ISIS-3 trial to investigate the causes of heart attacks.
ISIS-4
A randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Patients were randomised between July 1991 and August 1993. Read the results.
Our team
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Rory Collins
Emeritus Professor of Medicine and Epidemiology
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Richard Peto
Emeritus Professor of Medical Statistics and Epidemiology
