Methods: Ninety patients within 12 hours of acute STEMI were assigned to receive intravenous streptokinase (cases) (n = 45) or standard therapy (controls) (n = 45). Results: Using streptokinase reduced the risk of cardiogenic shock (OR= 0.08; 95% CI: 0.01 - 0.65) (adjusted for sex, max blood pressure, Killip class) and hospital mortality (OR= 0.11; 95% CI: 0.02 - 0.71) (adjusted for sex).