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myocardial revascularization in acute myocardial infarction for all type of patients, clinical trials results

accelerated t-PA versus APSAC
TAPS, 1992
front-loaded administration of rt-PA
versus
APSAC
patients with acute myocardial infarction.open
TIMI 4, 1994
front-loaded rt-PA
versus
APSAC
patients with acute myocardial infarction double blind
Follow-up duration: hospital stay
accelerated t-PA versus streptokinase
GUSTO tPA Hiv, 1993
tPA accéléré (15 mg en bolus, puis 0.75 mg/kg en 30 min sans dépasser 50 mg puis 0.5 mg/kg en 60 min sans dépasser 35 mg) + héparine en IV (5000 U en bolus, 1000 U/h (de préférence 1200 U/h si > 80 kg), poursuivi au moins 48 h)
versus
Streptokinase 1.5 MU en 60 min + héparine SC (12500 U 2 fois/j commencée 4h après thrombolytique) combiné à streptokinase (1.5 MU en 60 min) + héparine en IV (5000 U en bolus, puis 1000 U/h (1200 U/h si > 80 kg) poursuivi au moins 48 h)
Hommes et femmes
Follow-up duration: 30 d
International 15 countries
accelerated t-PA versus t-PA
RAAMI, 1992
100 mg of rt-PA accelerated 90-min regimen (15-mg bolus followed by 50 mg over 30 min, then 35 mg over 60 min)
versus
100 mg of rt-PA standard 3-h infusion regimen (an initial 10-mg bolus followed by 50 mg for the 1st h, then 20 mg/h for 2 h
patients with acute myocardial infarction within 6h from onset of chest painopen
Follow-up duration: hospital stay
US
anistreplase versus streptokinase
TEAM 2, 1991
anistreplase (30 units/2-5 min)
versus
streptokinase (1.5 million units/60 min
less than 76 years of age with electrocardiographic ST segment elevation who could be treated within 4 hours of symptom onsetdouble blind
APSAC versus control
APSIM, 1989
APSAC 30 U over 5 min
versus
control (conventional heparin therapy, 5,000 IU in a bolus injection)
patients with a first acute myocardial infarction within 5 h after the onset of symptomsopen
Follow-up duration: 3 weeks
France
APSAC versus placebo
AIMS, 1988
APSAC 30U IV in 5 min
versus
Placebo
Hommes et femmes, < 70 ansdouble blind
Follow-up duration: 1 y
German Multicenter Trial, 1988
APSAC 30 unités en IV en 5 min, puis héparine en IV (17 U/kg/h) 4 h après l'injection d'APSAC
versus
Héparine 5000 U en bolus en IV, puis 17 U/kg/h
Hommes et femmes, < 70 ans
Follow-up duration: 28 jours
APSAC versus streptokinase
ISIS III (SK/APSAC), 1992
Streptokinase 1.5 MU infused over about 1 h
versus
anisoylated plasminogen-streptokinase activator complex (APSAC), anistreplase: 30 U over about 3 min
patients within 24 h of the onset of suspected acute myocardial infarction double blind
Follow-up duration: 6 mo
International 17 countries
APSAC versus t-PA
TEAM 3, 1992
APSAC, 30 U/2 to 5 min
versus
rt-PA, 100 mg/3 h,
patient with ST elevalation within 4h of the onset of symptomsdouble blind
Follow-up duration: 1 months
bolus t-PA versus accelerated t-PA
COBALT, 1997
of 50 mg of alteplase over a period of 1 to 3 minutes followed 30 minutes later by a second bolus of 50 mg (or 40 mg for patients who weighed less than 60 kg).
versus
weight-adjusted, accelerated infusion of 100 mg of alteplase
patients with acute myocardial infarctiondouble blind
Follow-up duration: 30 days
drug-eluting stents versus bare-metal stent
DEDICATION, 2008
NCT00192868
DES currently used with or without distal protection
versus
BMS with or without distal protection
patients referred within 12 hours from symptom onset of an ST-elevation myocardial infarction open
Follow-up duration: 8 mo (15 mo, 3y)
Denmark.
PASEO, 2009
paclitaxel-eluting stents and sirolimus-eluting stents
versus
bare metal stent
patients with ST-elevation myocardial infarction within 12 hours from symptom onsetopen
Follow-up duration: 4.3 years
facilitated stenting versus alteplase
STOPAMI 1, 2000
stent plus abciximab
versus
intravenous alteplase
patients with acute myocardial infarctionopen
Follow-up duration: 6 months
immediate systematic ballon angioplastyte versus no immediate angioplasty
ECSG, 1988
angioplasty as soon as possible (after rtPA)
versus
non-invasive strategy without immediate CA and PTCA
patients with acute myocardial infarction within 5 h after onset of symptoms open
Follow-up duration: 1 y
Europe
Belenkie, 1991
immediate PTCA
versus
delayed PTCA (18-38h)
patients with a patent infarct-related artery after thrombolytic therapy suitable for angioplasty open
Follow-up duration: 4 months
Canada
Ellis, 1994
balloon angioplasty supplemented by further thrombolytic therapy as needed
versus
conservative therapy
patients with first anterior wall infarction treated with any accepted intravenous thrombolytic regimen and angiographically demonstrated to have an occluded infarct vessel within 8 hours of chest pain onset
Erbel, 1989
combined intravenous and intracoronary streptokinase with immediate coronary angioplasty
versus
combined intravenous and intracoronary streptokinase without immediate coronary angioplasty
patients with acute transmural myocardial infarction
Follow-up duration: 3 years
MERLIN (Sutton), 2004
emergency coronary angiography with rescue PCI
versus
conservative treatment
patients with STEMI and failed fibrinolysis
Follow-up duration: 30 days
SHOCK (Hochman), 1999
NCT00000552
emergency revascularization
versus
initial medical stabilization
patients with cardiogenic shock complicating acute MIopen
Follow-up duration: 30 days (6y)
US
SWISS-SMASH, 1999
emergency angiography, followed immediately by revascularization when indicated
versus
initial medical management
Patients with acute myocardial infarction and early shock open
Follow-up duration: 30 days (1y)
Europe
TAMI 1 pilot, 1987
Angioplasty within 120 min (after rtPA)
versus
defered CA (7-10 days) and angioplasty if indicated
patients with acute myocardial infarction.open
Follow-up duration: in hospital
USA
TAMI-5 (Califf), 1991
immediate catheterization with angioplasty for failed thrombolysis (90min after rtPA/urokinase)
versus
deferred predischarge catheterization on days 5-10, no PTCA planned
patient with acute myocardial infarction
TIMI 2A, 1988
CA within 120 min of the start of the rtPA infusion. PTCA whether the artery is open or closed
versus
CA within 18-48hrs. PTCA only if artery open (TIMI 2 or 3)
patient thrombolyzed for a AMIopen
Follow-up duration: 21 days
USA
Topol, 1987
immediate PTCA
versus
no PTCA
patients with evolving transmural myocardial infarctionopen
Follow-up duration: in hospital
USA
lanoteplase versus accelerated t-PA
InTIME-II, 2000
lanoteplase 120 KU. kg(-1) as a single intravenous bolus
versus
up to 100 mg accelerated alteplase given over 90 min
patients presenting within 6 h of onset of ST elevation acute myocardial infarctiondouble blind
Follow-up duration: 30 days
worldwide
paclitaxel eluting stent versus bare-metal stent
HAAMU-STENT, 2006
Taxus Express
versus
Bare-metal-stent
AMI - STEMI patients undergoing PCIopen
Follow-up duration: 12 months
Finland
HORIZONS-AMI Stent, 2008
paclitaxel-eluting stents (Taxus)
versus
BMS (Express)
ST-elevation myocardial infarctionopen
Follow-up duration: 1 year
PASSION, 2006
ISRCTN65027270
Taxus Express2
versus
Express2 or Liberté
Myocardial Infarction with ST-Segment Elevationopen
Follow-up duration: 12 months (5y)
The Netherlands
Prehospital thrombolysis versus at hospital thrombolysis
EMIP, 1993
anistreplase by mobile intensive care unit
versus
ND
Follow-up duration: ND
GREAT, 1994
anistreplase by general practitioner
versus
ND
Follow-up duration: ND
MITI, 1993
NCT00000468
rt-PA by paramedics
versus
ND
Follow-up duration: ND
Roth, 1990
rt-PA by mobile intensive care unit
versus
Barbash, 1990

versus
Castaigne, 1987

versus
Mcneill, 1989

versus
Schofer, 1990
urokinase by mobile intensive care unit
versus
Castaigne , 1989
anistreplase by mobile intensive care unit
versus
TEAHAT, 1990

versus
ND
Follow-up duration: ND
primary angioplasty versus immediate thrombolysis
MAASTRICHT (Vermeer), 1999
Transfer for primary PTCA
versus
immediate thrombolysis with tPA
patients with acute myocardial infarction initially admitted to a hospital without PTCA facilitiesopen
PRAGUE-1, 2000
immediate transportation for primary angioplasty without pre-treatment with thrombolysis
versus
immediate thrombolysis with streptokinase
patients with acute myocardial infarction, presenting within 6 h of symptom onset at community hospitals without a catheterization laboratoryopen
Follow-up duration: 30 days
AIR-PAMI, 2002
Transfer for Primary Angioplasty
versus
immediate thrombolysis (various thrombolytic)
Patients with high-risk AMI (age >70 years, anterior MI, Killip class II/III, heart rate >100 beats/min or systolic BP <100 mm Hg), eligible for thrombolytic therapy open
CAPTIM, 2002
Transfer for Primary Angioplasty
versus
prehospital fibrinolysis with accelerated alteplase
patients within 6 h of acute myocardial infarction with ST-segment elevation, initially managed by mobile emergency-care unitsopen
DANAMI-2, 2003
Transfer for Primary Angioplasty
versus
immediate thrombolysis with tPA (accelared infusion)
patients with myocardial infarction with ST-segment elevationopen
Follow-up duration: 30 days
PRAGUE-2, 2003
immediate transport for primary percutaneous coronary intervention
versus
immediate thrombolysis with streptokinase
patients with acute ST elevation myocardial infarction presenting within <12 h to the nearest community hospital without a catheter laboratoryopen
Follow-up duration: 30 days
primary ballon angioplasty versus accelerated t-PA
Ribichini, 1996
primary PTCA
versus
accelerated alteplase 90 min (15 mg IV bolus followed by an infusion of 0.75 mg/kg over 30min not to exceed 50mg, and then 0.5 mg/kg over the next 60min not to exceed 35mg for a total maximun of 100mg)
open
Follow-up duration: discharge
Italy
Garcia, 1997
primary PTCA
versus
accelerated t-PA 90 min (15 mg IV bolus followed by an infusion of 0.75 mg/kg over 30min not to exceed 50mg, and then 0.5 mg/kg over the next 60min not to exceed 35mg for a total maximun of 100mg)
patients with anterior AMI open
Follow-up duration: 30 d
Spain
GUSTO 2B, 1997
primary PTCA
versus
accelerated t-PA 90 min (15 mg IV bolus followed by an infusion of 0.75 mg/kg over 30min not to exceed 50mg, and then 0.5 mg/kg over the next 60min not to exceed 35mg for a total maximun of 100mg)
patients within 12 hours of acute myocardial infarction (with ST-segment elevation on the electrocardiogram)open
Follow-up duration: 30 d
USA, Europe, Australia
DANAMI-2, 1997
angioplasty
versus
accelerated treatment with intravenous alteplase
patients who received thrombolytic treatment for a first acute myocardial infarction and with inducible myocardial ischemia (either symptomatic angina pectoris presenting spontaneously > 36 hours after admission or during a predischarge exercise test or ST changes during exercise compatible with ischemia)open
Follow-up duration: 2.4y
primary ballon angioplasty versus duteplase
DeWood, 1989
primary PTCA
versus
duteplase 0.5 MU/kg for 1 h then 0.7 MU/kg/h for 3h
open
Follow-up duration: 30 d
USA
Gibbons, 1993
primary PTCA
versus
duteplase 0.6 MU/kg over 5h
patients with acute myocardial infarction open
Follow-up duration: discharge
USA
primary ballon angioplasty versus intracoronary streptokinase
O'Neill, 1986
coronary angioplasty
versus
intracoronary streptokinase
patients within 12 hours of their first symptoms of acute myocardial infarction open
primary ballon angioplasty versus streptokinase
Zwolle, 1994
primary PTCA
versus
streptokinase 1.5 M IU over 1h
patients with acute myocardial infarction open
Follow-up duration: discharge
The Netherland
Ribeiro, 1993
primary PTCA
versus
streptokinase 1.2 M IU over 1h
patients with ST segment elevation within 6 h of the onset of chest painopen
Follow-up duration: discharge
Brazil
Grinfeld, 1996
primary PTCA
versus
streptokinase 1.5 M IU over 1h
open
Follow-up duration: 30 d
Argentina
Zijlstra, 1997
primary PTCA
versus
streptokinase 1.5 M IU over 1h
atients with acute myocardial infarction open
Follow-up duration: 6 months
The Netherland
Zijlstra , 1993
immediate coronary angioplasty (without previous thrombolytic therapy)
versus
intravenous streptokinase
patients with acute myocardial infarction open
Akhras, 1997
primary angioplasty
versus
streptokinase
patient within 12hr from onset of AMIopen
Saudi Arabia
primary ballon angioplasty versus t-PA
PAMI, 1993
primary PTCA
versus
t-PA 100mg (or 1.25mg/kg for patients weighting less than 65kg) over 3 h
patients who presented within 12 hours of the onset of myocardial infarction open
Follow-up duration: discharge
USA,Europe
primary ballon angioplasty versus tenecteplase
TRIANA, 2009
NCT00257309
Tenecteplase + UFH (+/- clopidogrel)
versus
Primary angioplasty
>=75 years old with ST-segment elevation or LBBB AMI <6 hours of evolution without contraindications for thrombolytic therapy open
Follow-up duration: 30 days (12 months)
primary PCI versus accelerated t-PA
C-PORT, 2002
primary PCI without on-site cardiac surgery
versus
accelerated tissue plasminogen activator
thrombolytic-eligible patients with acute MI of less than 12 hours' duration associated with ST-segment elevation open
Follow-up duration: 6 months
USA
primary PCI versus Thrombolysis
senior PAMI, 2005
NCT00136929
primary percutaneous coronary intervention
versus
intravenous thrombolytic therapy
elderly (age >= 70 years) patients with acute myocardial infarctionOpen
Follow-up duration: 30 days
primary stenting versus accelerated t-PA
STAT, 2001
primary stenting
versus
accelerated t-PA
patients with acute ST-elevation myocardial infarction open
Follow-up duration: 6 months
primary stenting versus balloon angioplasty
Zwolle 5 (Suryapranata), 1998
Stent Palmaz-Schatz
versus
balloon angioplasty
Patients with acute myocardial infarction open
Follow-up duration: 12 months
FRESCO, 1998
elective stenting after successful primary PTCA
versus
no further intervention after successful primary PTCA
patient with successful primary PTCAopen
Follow-up duration: 12 months
GRAMI (Rodriguez), 1998
balloon angioplasty followed electively with Gianturco Roubin II stents
versus
conventional balloon angioplasty
patients with acute myocardial infarction within 24 hours after onset open
Follow-up duration: 12 months
PASTA (Saito), 1999
Stent Palmaz-Schatz
versus
primary balloon angioplasty
patients with AMI within 12 hr from onset open
Follow-up duration: 12 months
stent-PAMI (Grines), 1999
angioplasty with Stent Heparin-coated
versus
angioplasty alone
patients with acute myocardial infarction and with vessels suitable for stentingopen
Follow-up duration: 12 months
STENTIM-2 (Maillard), 2000
systematic stenting with Stent Wiktor
versus
conventional balloon angioplasty
patients with AMI <12 h from symptom onset, with an occluded native coronary arteryopen
Follow-up duration: 12 months
PSSAAMI (Scheller), 2001
Stent Wiktor GX
versus
primary angioplasty
patients within 24 hours after the onset of acute myocardial infarctionopen
Follow-up duration: 24 months
Jaksch, 1998
Various stent
versus
open
Follow-up duration: 6 months
PRISAM (Kawashima), 1999
Stent Palmaz-Schatz
versus
open
Follow-up duration: 6 months
CADILLAC (no abciximab), 2002
stenting alone with the MultiLink stent
versus
PTCA alone
patients with acute myocardial infarction open
Follow-up duration: 12 months
CADILLAC abciximab., 2002
stenting plus abciximab therapy
versus
PTCA plus abciximab therapy
patients with acute myocardial infarction open
Follow-up duration: 12 months
ZWOLLE 6, 2005
stenting
versus
balloon angioplasty
unselected patients with STEMIopen
Follow-up duration: 12 months
STOPAMI 3, 2004
coronary artery stenting
versus
PTCA
patients with AMI ineligible for thrombolysis (lack of ST-segment elevation on the electrocardiogram, late presentation >12 h after symptom onset, and contraindications to thrombolysis)open
Follow-up duration: 6 months
primary stenting versus immediate thrombolysis
STOPAMI 2, 2002
stenting combined with abciximab
versus
fibrinolysis by alteplase combined with abciximab
patients with acute myocardial infarction within 12 h of onset of symptomsopen
recombinant staphylokinase versus t-PA
STAR, 1995
recombinant staphylokinase (10 or 20 mg given intravenously over 30 minutes)
versus
weight-adjusted rt-PA over 90 minutes
patients with evolving myocardial infarction of < 6 hours' duration and with ST-segment elevation open
Follow-up duration: 90 min
Belgium
reteplase versus accelerated t-PA
GUSTO III, 1997
reteplase, in two bolus doses or 10 MU each given 30 minutes apart
versus
alteplase, up to 100 mg infused over a period of 90 minutes
patients within 6 hours after the onset of symptoms with ST-segment elevation or bundle-branch block open
Follow-up duration: 30 days
20 countries
RAPID-2, 1996
10 plus 10 megaunits double bolus of reteplase
versus
front-loaded alteplase
patients with acute myocardial infarction within 12h from onset of ischemic chest painopen
Follow-up duration: 35 days
USA, Germany
reteplase versus streptokinase
INJECT, 1995
Reteplase 2 bolus de 10 MU à 30 min d'intervalle
versus
Streptokinase 1.5 MU en IV en 60 min
patients with symptoms and electrocardiographic criteria consistent with acute myocardial infarction within 12 h from onset of symptoms double blind
Follow-up duration: 6 mo
Europe
saruplase versus streptokinase
COMPASS, 1998
saruplase 20-mg bolus and 60-mg infusion over 60 min
versus
streptokinase 1.5-MU infusion over 60 min
patients with symptoms compatible with those of acute myocardial infarction for < 6 hdouble blind
Follow-up duration: 1 y
PRIMI (vs SK), 1989
sarupalse 20 mg bolus followed by 60 mg infusion for 60 min
versus
1.5 million IU streptokinase infused over 60 min
patients with acute myocardial infarction were within 4 h of onset of symptoms double blind
Follow-up duration: ND
saruplase versus t-PA
SESAM, 1997
saruplase 80 mg/hour
versus
alteplase 100 mg every 3 hours
patients with acute myocardial infarction open
Follow-up duration: hospital stay
Europe
saruplase versus urokinase
PRIMI (vs UK), 1989
20 mg bolus followed by 60 mg infusion for 60 min
versus
80 mg recombinant pro-urokinase
with a first acute myocardial infarction within 4 h of onset of symptoms double blind
sirolimus eluting stent versus bare-metal stent
Díaz de la Llera, 2007
sirolimus-eluting stents
versus
uncoated stents
primary percutaneous coronary intervention for acute myocardial infarction with ST-segment elevationopen
Follow-up duration: 1y
Spain
MISSION, 2008
ISRCTN62825862
Cypher
versus
Vision
primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (<9h)single-blind
Follow-up duration: 12 months
the Netherlands
SESAMI, 2007
NCT00288210
Cypher
versus
BX stent, Cordis
AMIopen
Follow-up duration: 12 months
Italy
TYPHOON, 2006
NCT00232830
Cypher or CypherSelect
versus
any commerciallyavailable uncoated stent
AMIopen
Follow-up duration: 12 months
Worldwide (15 countries)
sirolimus eluting stent versus paclitaxel eluting stent
Di Lorenzo et al., 2005
sirolimus
versus
paclitaxel
ST-segment elevation myocardial infarctionopen
NA
Juwana, 2009
ISRCTN90526229
sirolimus coated Cypher stent
versus
paclitaxel coated Taxus stent
patients with STEMI undergoing primary PCIopen
Follow-up duration: 9 months (12 months)
The Netherlands
PROSIT, 2006
SES Cordis
versus
PES Boston Scientific
AMI or persistent ischaemia 12-24hopen
Follow-up duration: 1 year
Korea
streptokinase versus placebo
EMERAS (7-12h), 1993
intravenous streptokinase 1.5 MU
versus
placebo
patients presenting 7-12 h from symptom onsetdouble blind
EMERAS (all delay), 1993
streptokinase 1.5 MU
versus
placebo
patients entering hospital up to 24 h after the onset of suspected acute myocardial infarctiondouble blind
south america
GISSI I, 1986
Streptokinase 1.5 MU en perfusion IV en 1 heure
versus
usual care
patients within 12 h after the onset of symptoms and with no contraindications to SK open
Follow-up duration: 1 y
ISAM, 1986
1.5 million IU of streptokinase over 1h
versus
Placebo
patients within six hours after the onset of symptoms of myocardial infarctiondouble blind
Follow-up duration: 21 days
ISIS 2 pilot, 1987
streptokinase 1.5 MU
versus
placebo
patients with suspected acute myocardial infarction double blind
ISIS-2 (SK), 1988
1-hour intravenous infusion of 1.5 MU of streptokinase
versus
Placebo
patients within 24h of the onset of suspected acute myocardial infarction double blind
Follow-up duration: 15 mo
Western Washington Intravenous Trial, 1988
NCT00000507
Streptokinase en IV, 1.5 M UI en 60 min après injection de benadryl 50 mg en IV et hydrocortisone 100 mg en IV; héparine en IV 1000 UI/h 2h après la streptokinase puis warfarine pendant au moins 3 mois
versus
Traitement standard, avec ou sans anticoagulant (décidé par le médecin)
Hommes et femmes, < ou = 75 ans
Follow-up duration: 1.4 y
systematic ballon angioplasty versus no systematic angioplasty
SWIFT, 1991
CA 72h with a view to PTCA or CABG
versus
elective angioplasty (only if required by clinical indication)
patients presenting with clinical and electrocardiographic features of acute myocardial infarction up to three hours after the onset of major symptomsOpen
Follow-up duration: 1 y
UK
SIAM, 1992
CA with CABG/PTCA 14-48 hours
versus
no CA within the first 21days unless evidence of ischemia
patients treated by thrombolysis for AMIOpen
Follow-up duration: <3 years
Europe
TAMI 6, 1992
PTCA 6-24h after rtPA
versus
no PTCA planned
Barbash, 1990
PTCA>72h after rtPA if stenosis>70%
versus
PTCA>72h after rtPA if stenosis>50% and ischemia
Guerci, 1987
PTCA at 4 day
versus
no PTCA during the 10 days study period
patients candidate to PTCA determined at the 1st day CA
Follow-up duration: 10 days
United states
TIMI 2, 1989
CA 18 to 48 hrs
versus
no CA unless spontaneous or exercise induced ischemia
patients treated with intravenous recombinant tissue plasminogen activator (rt-PA) within four hours of the onset of chest pain thought to be caused by myocardial infarctionOpen
Follow-up duration: 6 we
United states
TIMI II-A (defered), 0
delayed invasive strategy, deferred angiography and PTCA for 18-48 hours
versus
conservative approach
TOPS, 1992
PTCA to be performed 4-14 days after MI
versus
conservative management, no PTCA
patients with residual stenoses after thrombolytic treatment of myocardial infarction
Follow-up duration: 12 months
Van den Brand, 1991
CA at 2-5 days, PTCA if suitable lesion
versus
CA at 2-5 days but no PTCA
suitable lesionNA
Follow-up duration: 3 mo
Europe
Vermeer, 1999
alteplase followed by transfer to the PTCA centre and (if indicated) rescue PTCA
versus
thrombolytic treatment with alteplase
patients with acute myocardial infarction initially admitted to a hospital without PTCA facilities
Follow-up duration: 42 days
systematic PCI (+stent) versus no systematic PCI
CAPITAL AMI, 2005
TNK-facilitated angioplasty
versus
TNK alone
patients with high-risk ST-segment elevation myocardial infarction
Follow-up duration: 6 months
GRACIA-1, 2004
angiography and intervention if indicated within 24 h of thrombolysis
versus
ischaemia-guided conservative approach
patients with thrombolysed STEMI (with recombinant tissue plasminogen activator)
Follow-up duration: 12 months
PRAGUE, 2000
thrombolysis during immediate transportation for coronary angioplasty
versus
thrombolysis in a community hospital
patients with acute ST elevation myocardial infarction presenting to community hospitals
Follow-up duration: 12 months
SIAM III, 2002
immediate stenting after thrombolysis
versus
conservative treatment
patients receiving thrombolysis in AMI (<12 h)
Follow-up duration: 6 months
Germany
WEST, 2006
TNK and mandatory invasive study <= 24 h, including rescue PCI for reperfusion failure
versus
tenecteplase (TNK) and usual care
STEMI patients (> 4 mm ST-elevation/deviation) within 6 h of symptom onse
Follow-up duration: 30 days
Canada
t-PA versus placebo
ASSET, 1988
rt-PA 100 mg
versus
Placebo
patient with suspected acute myocardial infarction double blind
Follow-up duration: 6 months
LATE, 1993
intravenous alteplase (100 mg over 3 h)
versus
placebo
patients with symptoms and electrocardiographic criteria consistent with AMI between 6 and 24 h from symptom onsetdouble blind
Follow-up duration: 6 mo
TAMI 6, 1992
tissue-type plasminogen activator 100 mg over 2 hours
versus
placebo
patients with 6 to 24 hours of symptoms and ECG ST elevation double blind
Follow-up duration: 6 months
USA
t-PA versus streptokinase
International Study Group, 1990
tPA 100 mg en IV en 3 h (10 mg en bolus, puis 50 mg en 1 h, puis 20 mg/h pendant 2 h)
versus
Streptokinase 1.5 MU en IV de 30 à 60 min
patients with suspected acute myocardial infarction of less than 6 h duration double blind
Follow-up duration: 6 mo
Centre Illinois, 1993
t-PA 10 mg bolus, followed by 50 mg in the first hour, and 20 mg/hour for the next 2 hours
versus
SK 375 000 IU bolus, followed by 1 125 000 IU/1 hage/pj
patients with AMI within 3h from onset of chest painsingle blind
USA
Cherng, 1992
100 mg of rTPA over 3 hours (with early heparinization)
versus
1,500,000 units of streptokinase over 1 hour
patients with acute myocardial infarction open
Follow-up duration: hospital stay
Taiwan
ECSG, 1985
0.75 mg rt-PA/kg over 90 min
versus
1 500 000 IU streptokinase over 60 min
patients with acute myocardial infarction of less than 6 h durationsingle-blind
Europe
GISSI II, 1990
alteplase 100 mg infused intravenously over 3 h
versus
streptokinase 1.5 MU infused intravenously over 30-60 min
patients with acute myocardial infarction within 6 h from onset of symptomsopen
Follow-up duration: 6 mo
International 14 countries
ISIS III (SK/tPA), 1992
Streptokinase 1.5 MU en IV d'une heure
versus
tPA 0.04 MU/kg en IV en bolus d'1 min, puis 0.36 MU/kg en 1 h, puis 0.067 MU/kg/h pendant 3 h
Hommes et femmesdouble blind
Follow-up duration: 6 mo
International 17 countries
PAIMS, 1989
intravenous cumulative dose of 100 mg rt-PA
versus
.5 million units streptokinase
patients with acute myocardial infarction less than 3 h oldopen
Italy
TIMI-1, 1987
NCT00000505
rt-PA, 40, 20, and 20 mg in successive hours
versus
SK 1.5 million units over 1 hr
patients with evolving acute myocardial infarction within 7 hr of the onset of symptoms double blind
USA
White, 1989
rt-PA 100 mg over three hours
versus
streptokinase 1.5 million units over 30 minutes
patients with AMIdouble blind
New Zealand
t-PA versus urokinase
TAMI 5 (t-PA vs uroK), 1991
accelerated t-PA 100mg over 3h
versus
urokinase IV bolus 1.5 MU followed by 1.5 MU over 90min
patient with acute myocardial infarctionopen
t-PA + streptokinase versus streptokinase
GUSTO tPA-SK Hiv, 1993
tPA en IV 1 mg/kg, sans dépasser 90 mg, dont 10 % en bolus + streptokinase 1 MU en 60 min + héparine en IV (5000 U en bolus, 1000 U/h (de préférence 1200 U/h si > 80 kg), poursuivi au moins 48 h)
versus
Streptokinase 1.5 MU en 60 min + héparine SC (12500 U 2 fois/j commencée 4h après thrombolytique) combiné à streptokinase (1.5 MU en 60 min) + héparine en IV (5000 U en bolus, puis 1000 U/h (1200 U/h si > 80 kg) poursuivi au moins 48 h)
Hommes et femmes
Follow-up duration: 30 d
International 15 countries
t-PA + urokinase versus t-PA
TAMI 5 (t-PA+uroK vs tPA), 1991
t-PA + urokinase
versus
t-PA
patient with acute myocardial infarction open
t-PA half dose versus t-PA
KAMIT, 1991
half-dose (50 mg) t-PA with streptokinase (1.5 MU) during 1 hour
versus
t-PA (100 mg) during 3 hours
patients within 6 hours of myocardial infarction open
Follow-up duration: hospital stay
USA
tenecteplase versus accelerated t-PA
ASSENT-2, 1999
Tenecteplase en IV bolus (dose en fonction du poids: 30 mg si < 60 kg; 35 mg si poids entre 60 et 69.9 kg; 40 mg pour les 80-89.9 kg; 50 mg si > ou = 90 kg
versus
Alteplase en IV, bolus de 15 mg, puis 0.75 mg/kg (sans dépasser 50 mg) en 30 min puis 0.50 mg/kg (sans dépasser 35 mg) en 60 min
patients with acute myocardial infarction of less than 6 h duration double blind
Follow-up duration: 30d
29 countries
thrombolysis + angioplasty versus immediate thrombolysis
NORDISTEMI, 2009
NCT00161005
transfer for immediate coronary angiography and intervention
versus
concervative strategy
patients with STEMI of less than 6 hours of duration and more than 90 minutes expected time delay to PCIopen
Follow-up duration: 1y
Norway
CARESS, 2008
immediate transfer for PCI after half-dose reteplase, abciximab, heparin, and aspirin
versus
half-dose reteplase, abciximab, heparin, and aspirin, transfer for PCI only if they had persistent ST elevation at 90 minutes (rescue PCI)
STEMI patients under 75 years old within 12 hours of symptom onset who had been admitted to hospitals without PCI facilitiesopen
Follow-up duration: 30 days
France, Italy, and Poland
CAPITAL AMI, 2005
full-dose tenecteplase (TNK) plus PCI
versus
thrombolysis alone
high-risk MI patients within six hours of symptom onset open
Follow-up duration: 6 months
US
PRAGUE-1 (thrombolysis+PTCA), 2000
thrombolytic therapy during transportation to angioplasty
versus
immediate thrombolysis with streptokinase
patients with acute myocardial infarction, presenting within 6 h of symptom onset at community hospitals without a catheterization laboratory open
Follow-up duration: 30 days
Czech Republic
transfer for primary angioplasty versus immediate thrombolysis
AIR-PAMI , 2002
Transfer for Primary Angioplasty
versus
immediate thrombolysis (various thrombolytic)
Patients with high-risk AMI (age >70 years, anterior MI, Killip class II/III, heart rate >100 beats/min or systolic BP <100 mm Hg), eligible for thrombolytic therapy open
DANAMI-2 , 2003
Transfer for Primary Angioplasty
versus
immediate thrombolysis with tPA (accelared infusion)
patients with myocardial infarction with ST-segment elevationopen
Follow-up duration: 30 days
PRAGUE-2 , 2003
immediate transport for primary percutaneous coronary intervention
versus
immediate thrombolysis with streptokinase
patients with acute ST elevation myocardial infarction presenting within <12 h to the nearest community hospital without a catheter laboratoryopen
Follow-up duration: 30 days
urokinase versus control
USIM, 1991
urokinase bolus dose of 1 million U repeated after 60 minutes plus heparin
versus
control (heparin alone)
patients with acute myocardial infarction within 4 hours of the onset of pain open
Follow-up duration: in hospital
Italy
zotarolimus eluting stent versus paclitaxel eluting stent
ZEST AMI (vs PES), 2009
NCT00422565
zotarolimus-eluting stent (Endeavor)
versus
paclitaxel-eluting stent (Taxus Liberté)
Acute Myocardial Infarction Patients (STEMI)requiring primary angioplasty with symptom onset <= 12 hours open
Follow-up duration: 1 year (mean)
Korea
zotarolimus eluting stent versus sirolimus eluting stent
ZEST AMI (vs SES), 2009
NCT00422565
zotarolimus-eluting stent (Endeavor)
versus
sirolimus-eluting stents (Cypher)
Acute Myocardial Infarction Patients (STEMI)requiring primary angioplasty with symptom onset <= 12 hours open
Follow-up duration: 1 year (mean)
Korea

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