acute myocardial infarction - myocardial revascularization - all type of patients clinical trials results meta-analysis

<h1> <a href="index.html"> <strong>acute myocardial infarction</strong> - myocardial revascularization </a> - all type of patients trial results systematic overview and meta-analysis </h1> <h2>Main characteristics of the included studies</h2> <table> <tr> <th>Trial</th> <th>Treatments</th> <th>Patients</th> <th>Methods</th> </tr> <tr> <td> <a href="index.html"> Zwolle, 1994 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> streptokinase 1.5 M IU over 1h </td> <td> patients with acute myocardial infarction </td> <td> follow-up discharge<br> n=152/149<br> Parallel groups<br> open <br> The Netherland </td> </tr> <tr> <td> <a href="index.html"> Ribeiro, 1993 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> streptokinase 1.2 M IU over 1h </td> <td> patients with ST segment elevation within 6 h of the onset of chest pain </td> <td> follow-up discharge<br> n=50/50<br> Parallel groups<br> open <br> Brazil </td> </tr> <tr> <td> <a href="index.html"> Grinfeld, 1996 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> streptokinase 1.5 M IU over 1h </td> <td> </td> <td> follow-up 30 d<br> n=54/58<br> Parallel groups<br> open <br> Argentina </td> </tr> <tr> <td> <a href="index.html"> Zijlstra, 1997 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> streptokinase 1.5 M IU over 1h </td> <td> atients with acute myocardial infarction </td> <td> follow-up 6 months<br> n=45/50<br> Parallel groups<br> open <br> The Netherland </td> </tr> <tr> <td> <a href="index.html"> DeWood, 1989 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> duteplase 0.5 MU/kg for 1 h then 0.7 MU/kg/h for 3h </td> <td> </td> <td> follow-up 30 d<br> n=46/44<br> Parallel groups<br> open <br> USA </td> </tr> <tr> <td> <a href="index.html"> PAMI, 1993 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> t-PA 100mg (or 1.25mg/kg for patients weighting less than 65kg) over 3 h </td> <td> patients who presented within 12 hours of the onset of myocardial infarction </td> <td> follow-up discharge<br> n=195/200<br> Parallel groups<br> open <br> USA,Europe </td> </tr> <tr> <td> <a href="index.html"> Gibbons, 1993 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> duteplase 0.6 MU/kg over 5h </td> <td> patients with acute myocardial infarction </td> <td> follow-up discharge<br> n=47/56<br> Parallel groups<br> open <br> USA </td> </tr> <tr> <td> <a href="index.html"> Ribichini, 1996 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> 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) </td> <td> </td> <td> follow-up discharge<br> n=24/26<br> Parallel groups<br> open <br> Italy </td> </tr> <tr> <td> <a href="index.html"> Garcia, 1997 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> 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) </td> <td> patients with anterior AMI </td> <td> follow-up 30 d<br> n=95/94<br> Parallel groups<br> open <br> Spain </td> </tr> <tr> <td> <a href="index.html"> GUSTO 2B, 1997 </a> <br> </td> <td> primary PTCA<br>  <i>versus</i> <br> 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) </td> <td> patients within 12 hours of acute myocardial infarction (with ST-segment elevation on the electrocardiogram) </td> <td> follow-up 30 d<br> n=573/565<br> factorial design<br> open <br> USA, Europe, Australia </td> </tr> <tr> <td> <a href="index.html"> GUSTO tPA Hiv, 1993 </a> <br> </td> <td> tPA acc�l�r� (15 mg en bolus, puis 0.75 mg/kg en 30 min sans d�passer 50 mg puis 0.5 mg/kg en 60 min sans d�passer 35 mg) + h�parine en IV (5000 U en bolus, 1000 U/h (de pr�f�rence 1200 U/h si > 80 kg), poursuivi au moins 48 h)<br>  <i>versus</i> <br> Streptokinase 1.5 MU en 60 min + h�parine SC (12500 U 2 fois/j commenc�e 4h apr�s thrombolytique) combin� � streptokinase (1.5 MU en 60 min) + h�parine en IV (5000 U en bolus, puis 1000 U/h (1200 U/h si > 80 kg) poursuivi au moins 48 h) </td> <td> Hommes et femmes </td> <td> follow-up 30 d<br> n=10396/20251<br> Parallel groups<br> <br> International 15 countries </td> </tr> <tr> <td> <a href="index.html"> ISAM, 1986 </a> <br> </td> <td> 1.5 million IU of streptokinase over 1h<br>  <i>versus</i> <br> Placebo </td> <td> patients within six hours after the onset of symptoms of myocardial infarction </td> <td> follow-up 21 days<br> n=859/882<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> AIMS, 1988 </a> <br> </td> <td> APSAC 30U IV in 5 min<br>  <i>versus</i> <br> Placebo </td> <td> Hommes et femmes, < 70 ans </td> <td> follow-up 1 y<br> n=624/634<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> ISIS-2 (SK), 1988 </a> <br> </td> <td> 1-hour intravenous infusion of 1.5 MU of streptokinase<br>  <i>versus</i> <br> Placebo </td> <td> patients within 24h of the onset of suspected acute myocardial infarction </td> <td> follow-up 15 mo<br> n=8592/8595<br> plan factoriel 2*2<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> ASSET, 1988 </a> <br> </td> <td> rt-PA 100 mg<br>  <i>versus</i> <br> Placebo </td> <td> patient with suspected acute myocardial infarction </td> <td> follow-up 6 months<br> n=2516/2495<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> Western Washington Intravenous Trial, 1988 </a> <br> NCT00000507 </td> <td> Streptokinase en IV, 1.5 M UI en 60 min apr�s injection de benadryl 50 mg en IV et hydrocortisone 100 mg en IV; h�parine en IV 1000 UI/h 2h apr�s la streptokinase puis warfarine pendant au moins 3 mois<br>  <i>versus</i> <br> Traitement standard, avec ou sans anticoagulant (d�cid� par le m�decin) </td> <td> Hommes et femmes, < ou = 75 ans </td> <td> follow-up 1.4 y<br> n=191/177<br> Parallel groups<br> <br> </td> </tr> <tr> <td> <a href="index.html"> German Multicenter Trial, 1988 </a> <br> </td> <td> APSAC 30 unit�s en IV en 5 min, puis h�parine en IV (17 U/kg/h) 4 h apr�s l'injection d'APSAC<br>  <i>versus</i> <br> H�parine 5000 U en bolus en IV, puis 17 U/kg/h </td> <td> Hommes et femmes, < 70 ans </td> <td> follow-up 28 jours<br> n=162/151<br> Parallel groups<br> <br> </td> </tr> <tr> <td> <a href="index.html"> GISSI II, 1990 </a> <br> </td> <td> alteplase 100 mg infused intravenously over 3 h<br>  <i>versus</i> <br> streptokinase 1.5 MU infused intravenously over 30-60 min </td> <td> patients with acute myocardial infarction within 6 h from onset of symptoms </td> <td> follow-up 6 mo<br> n=6182/6199<br> Plan factoriel 2*2 <br> open <br> International 14 countries </td> </tr> <tr> <td> <a href="index.html"> International Study Group, 1990 </a> <br> </td> <td> 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)<br>  <i>versus</i> <br> Streptokinase 1.5 MU en IV de 30 � 60 min </td> <td> patients with suspected acute myocardial infarction of less than 6 h duration </td> <td> follow-up 6 mo<br> n=10372/10396<br> Plan factoriel 2*2<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> GISSI I, 1986 </a> <br> </td> <td> Streptokinase 1.5 MU en perfusion IV en 1 heure<br>  <i>versus</i> <br> usual care </td> <td> patients within 12 h after the onset of symptoms and with no contraindications to SK </td> <td> follow-up 1 y<br> n=5860/5852<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> ISIS III (SK/APSAC), 1992 </a> <br> </td> <td> Streptokinase 1.5 MU infused over about 1 h<br>  <i>versus</i> <br> anisoylated plasminogen-streptokinase activator complex (APSAC), anistreplase: 30 U over about 3 min </td> <td> patients within 24 h of the onset of suspected acute myocardial infarction </td> <td> follow-up 6 mo<br> n=13780/13773<br> Plan factoriel 3 (ou 4) *2<br> double blind <br> International 17 countries </td> </tr> <tr> <td> <a href="index.html"> COMPASS, 1998 </a> <br> </td> <td> saruplase 20-mg bolus and 60-mg infusion over 60 min<br>  <i>versus</i> <br> streptokinase 1.5-MU infusion over 60 min </td> <td> patients with symptoms compatible with those of acute myocardial infarction for < 6 h </td> <td> follow-up 1 y<br> n=1542/1547<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> GUSTO tPA-SK Hiv, 1993 </a> <br> </td> <td> tPA en IV 1 mg/kg, sans d�passer 90 mg, dont 10 % en bolus + streptokinase 1 MU en 60 min + h�parine en IV (5000 U en bolus, 1000 U/h (de pr�f�rence 1200 U/h si > 80 kg), poursuivi au moins 48 h)<br>  <i>versus</i> <br> Streptokinase 1.5 MU en 60 min + h�parine SC (12500 U 2 fois/j commenc�e 4h apr�s thrombolytique) combin� � streptokinase (1.5 MU en 60 min) + h�parine en IV (5000 U en bolus, puis 1000 U/h (1200 U/h si > 80 kg) poursuivi au moins 48 h) </td> <td> Hommes et femmes </td> <td> follow-up 30 d<br> n=10374/20251<br> Parallel groups<br> <br> International 15 countries </td> </tr> <tr> <td> <a href="index.html"> GUSTO III, 1997 </a> <br> </td> <td> reteplase, in two bolus doses or 10 MU each given 30 minutes apart<br>  <i>versus</i> <br> alteplase, up to 100 mg infused over a period of 90 minutes </td> <td> patients within 6 hours after the onset of symptoms with ST-segment elevation or bundle-branch block </td> <td> follow-up 30 days<br> n=10138/4921<br> Parallel groups<br> open <br> 20 countries </td> </tr> <tr> <td> <a href="index.html"> INJECT, 1995 </a> <br> </td> <td> Reteplase 2 bolus de 10 MU � 30 min d'intervalle<br>  <i>versus</i> <br> Streptokinase 1.5 MU en IV en 60 min </td> <td> patients with symptoms and electrocardiographic criteria consistent with acute myocardial infarction within 12 h from onset of symptoms </td> <td> follow-up 6 mo<br> n=3004/3006<br> Parallel groups<br> double blind <br> Europe </td> </tr> <tr> <td> <a href="index.html"> PRIMI (vs SK), 1989 </a> <br> </td> <td> sarupalse 20 mg bolus followed by 60 mg infusion for 60 min<br>  <i>versus</i> <br> 1.5 million IU streptokinase infused over 60 min </td> <td> patients with acute myocardial infarction were within 4 h of onset of symptoms </td> <td> follow-up ND<br> n=198/203<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> SESAM, 1997 </a> <br> </td> <td> saruplase 80 mg/hour<br>  <i>versus</i> <br> alteplase 100 mg every 3 hours </td> <td> patients with acute myocardial infarction </td> <td> follow-up hospital stay<br> n=236/237<br> Parallel groups<br> open <br> Europe </td> </tr> <tr> <td> <a href="index.html"> COBALT, 1997 </a> <br> </td> <td> 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).<br>  <i>versus</i> <br> weight-adjusted, accelerated infusion of 100 mg of alteplase </td> <td> patients with acute myocardial infarction </td> <td> follow-up 30 days<br> n=3585/3584<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> ASSENT-2, 1999 </a> <br> </td> <td> 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<br>  <i>versus</i> <br> Alteplase en IV, bolus de 15 mg, puis 0.75 mg/kg (sans d�passer 50 mg) en 30 min puis 0.50 mg/kg (sans d�passer 35 mg) en 60 min </td> <td> patients with acute myocardial infarction of less than 6 h duration </td> <td> follow-up 30d<br> n=8461/8488<br> Parallel groups<br> double blind <br> 29 countries </td> </tr> <tr> <td> <a href="index.html"> InTIME-II, 2000 </a> <br> </td> <td> lanoteplase 120 KU. kg(-1) as a single intravenous bolus<br>  <i>versus</i> <br> up to 100 mg accelerated alteplase given over 90 min </td> <td> patients presenting within 6 h of onset of ST elevation acute myocardial infarction </td> <td> follow-up 30 days<br> n=10038/5022<br> Parallel groups<br> double blind <br> worldwide </td> </tr> <tr> <td> <a href="index.html"> ISIS III (SK/tPA), 1992 </a> <br> </td> <td> Streptokinase 1.5 MU en IV d'une heure<br>  <i>versus</i> <br> 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 </td> <td> Hommes et femmes </td> <td> follow-up 6 mo<br> n=13780/13746<br> Plan factoriel 3 (ou 4) *2<br> double blind <br> International 17 countries </td> </tr> <tr> <td> <a href="index.html"> TEAHAT, 1990 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up ND<br> n=-9/-9<br> <br> ND <br> </td> </tr> <tr> <td> <a href="index.html"> MITI, 1993 </a> <br> NCT00000468 </td> <td> rt-PA by paramedics<br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up ND<br> n=175/175<br> <br> ND <br> </td> </tr> <tr> <td> <a href="index.html"> GREAT, 1994 </a> <br> </td> <td> anistreplase by general practitioner<br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up ND<br> n=163/148<br> <br> ND <br> </td> </tr> <tr> <td> <a href="index.html"> EMIP, 1993 </a> <br> </td> <td> anistreplase by mobile intensive care unit<br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up ND<br> n=2750/2719<br> <br> ND <br> </td> </tr> <tr> <td> <a href="index.html"> TAMI 1 pilot, 1987 </a> <br> </td> <td> Angioplasty within 120 min (after rtPA)<br>  <i>versus</i> <br> defered CA (7-10 days) and angioplasty if indicated </td> <td> patients with acute myocardial infarction. </td> <td> follow-up in hospital<br> n=99/98<br> parallel group<br> open <br> USA </td> </tr> <tr> <td> <a href="index.html"> ECSG, 1988 </a> <br> </td> <td> angioplasty as soon as possible (after rtPA)<br>  <i>versus</i> <br> non-invasive strategy without immediate CA and PTCA </td> <td> patients with acute myocardial infarction within 5 h after onset of symptoms </td> <td> follow-up 1 y<br> n=183/184<br> parallel group<br> open <br> Europe </td> </tr> <tr> <td> <a href="index.html"> SWIFT, 1991 </a> <br> </td> <td> CA 72h with a view to PTCA or CABG<br>  <i>versus</i> <br> elective angioplasty (only if required by clinical indication) </td> <td> patients presenting with clinical and electrocardiographic features of acute myocardial infarction up to three hours after the onset of major symptoms </td> <td> follow-up 1 y<br> n=397/403<br> Parallel groups<br> Open <br> UK </td> </tr> <tr> <td> <a href="index.html"> SIAM, 1992 </a> <br> </td> <td> CA with CABG/PTCA 14-48 hours<br>  <i>versus</i> <br> no CA within the first 21days unless evidence of ischemia </td> <td> patients treated by thrombolysis for AMI </td> <td> follow-up <3 years<br> n=158/166<br> Parallel groups<br> Open <br> Europe </td> </tr> <tr> <td> <a href="index.html"> TIMI 2, 1989 </a> <br> </td> <td> CA 18 to 48 hrs<br>  <i>versus</i> <br> no CA unless spontaneous or exercise induced ischemia </td> <td> 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 infarction </td> <td> follow-up 6 we<br> n=1636/1626<br> Factorial plan<br> Open <br> United states </td> </tr> <tr> <td> <a href="index.html"> Guerci, 1987 </a> <br> </td> <td> PTCA at 4 day <br>  <i>versus</i> <br> no PTCA during the 10 days study period </td> <td> patients candidate to PTCA determined at the 1st day CA </td> <td> follow-up 10 days<br> n=42/43<br> Factorial plan<br> <br> United states </td> </tr> <tr> <td> <a href="index.html"> Van den Brand, 1991 </a> <br> </td> <td> CA at 2-5 days, PTCA if suitable lesion <br>  <i>versus</i> <br> CA at 2-5 days but no PTCA </td> <td> suitable lesion </td> <td> follow-up 3 mo<br> n=113/104<br> Parallel groups<br> NA <br> Europe </td> </tr> <tr> <td> <a href="index.html"> TOPS, 1992 </a> <br> </td> <td> PTCA to be performed 4-14 days after MI<br>  <i>versus</i> <br> conservative management, no PTCA </td> <td> patients with residual stenoses after thrombolytic treatment of myocardial infarction </td> <td> follow-up 12 months<br> n=42/45<br> Parallel groups<br> <br> </td> </tr> <tr> <td> <a href="index.html"> Jaksch, 1998 </a> <br> </td> <td> Various stent <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up 6 months<br> n=231/231<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> GRAMI (Rodriguez), 1998 </a> <br> </td> <td> balloon angioplasty followed electively with Gianturco Roubin II stents<br>  <i>versus</i> <br> conventional balloon angioplasty </td> <td> patients with acute myocardial infarction within 24 hours after onset </td> <td> follow-up 12 months<br> n=52/52<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> Zwolle 5 (Suryapranata), 1998 </a> <br> </td> <td> Stent Palmaz-Schatz<br>  <i>versus</i> <br> balloon angioplasty </td> <td> Patients with acute myocardial infarction </td> <td> follow-up 12 months<br> n=112/115<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> stent-PAMI (Grines), 1999 </a> <br> </td> <td> angioplasty with Stent Heparin-coated<br>  <i>versus</i> <br> angioplasty alone </td> <td> patients with acute myocardial infarction and with vessels suitable for stenting </td> <td> follow-up 12 months<br> n=452/448<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PASTA (Saito), 1999 </a> <br> </td> <td> Stent Palmaz-Schatz<br>  <i>versus</i> <br> primary balloon angioplasty </td> <td> patients with AMI within 12 hr from onset </td> <td> follow-up 12 months<br> n=67/70<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PRISAM (Kawashima), 1999 </a> <br> </td> <td> Stent Palmaz-Schatz <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up 6 months<br> n=110/112<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> STENTIM-2 (Maillard), 2000 </a> <br> </td> <td> systematic stenting with Stent Wiktor<br>  <i>versus</i> <br> conventional balloon angioplasty </td> <td> patients with AMI <12 h from symptom onset, with an occluded native coronary artery </td> <td> follow-up 12 months<br> n=101/110<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PSSAAMI (Scheller), 2001 </a> <br> </td> <td> Stent Wiktor GX<br>  <i>versus</i> <br> primary angioplasty </td> <td> patients within 24 hours after the onset of acute myocardial infarction </td> <td> follow-up 24 months<br> n=44/44<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PASSION, 2006 </a> <br> ISRCTN65027270 </td> <td> Taxus Express2<br>  <i>versus</i> <br> Express2 or Libert� </td> <td> Myocardial Infarction with ST-Segment Elevation </td> <td> follow-up 12 months (5y)<br> n=310/309<br> Parallel groups<br> open <br> The Netherlands </td> </tr> <tr> <td> <a href="index.html"> HAAMU-STENT, 2006 </a> <br> </td> <td> Taxus Express<br>  <i>versus</i> <br> Bare-metal-stent </td> <td> AMI - STEMI patients undergoing PCI </td> <td> follow-up 12 months<br> n=70/75<br> Parallel groups<br> open <br> Finland </td> </tr> <tr> <td> <a href="index.html"> TYPHOON, 2006 </a> <br> NCT00232830 </td> <td> Cypher or CypherSelect<br>  <i>versus</i> <br> any commerciallyavailable uncoated stent </td> <td> AMI </td> <td> follow-up 12 months<br> n=356/359<br> Parallel groups<br> open <br> Worldwide (15 countries) </td> </tr> <tr> <td> <a href="index.html"> SESAMI, 2007 </a> <br> NCT00288210 </td> <td> Cypher<br>  <i>versus</i> <br> BX stent, Cordis </td> <td> AMI </td> <td> follow-up 12 months<br> n=160/160<br> Parallel groups<br> open <br> Italy </td> </tr> <tr> <td> <a href="index.html"> MISSION, 2008 </a> <br> ISRCTN62825862 </td> <td> Cypher<br>  <i>versus</i> <br> Vision </td> <td> primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (<9h) </td> <td> follow-up 12 months<br> n=158/152<br> Parallel groups<br> single-blind <br> the Netherlands </td> </tr> <tr> <td> <a href="index.html"> PROSIT, 2006 </a> <br> </td> <td> SES Cordis<br>  <i>versus</i> <br> PES Boston Scientific </td> <td> AMI or persistent ischaemia 12-24h </td> <td> follow-up 1 year<br> n=154/154<br> Parallel groups<br> open <br> Korea </td> </tr> <tr> <td> <a href="index.html"> Di Lorenzo et al., 2005 </a> <br> </td> <td> sirolimus<br>  <i>versus</i> <br> paclitaxel </td> <td> ST-segment elevation myocardial infarction </td> <td> follow-up <br> n=90/90<br> Parallel groups<br> open <br> NA </td> </tr> <tr> <td> <a href="index.html"> ZEST AMI (vs PES), 2009 </a> <br> NCT00422565 </td> <td> zotarolimus-eluting stent (Endeavor) <br>  <i>versus</i> <br> paclitaxel-eluting stent (Taxus Libert�) </td> <td> Acute Myocardial Infarction Patients (STEMI)requiring primary angioplasty with symptom onset <= 12 hours </td> <td> follow-up 1 year (mean)<br> n=108/110<br> <br> open <br> Korea </td> </tr> <tr> <td> <a href="index.html"> D�az de la Llera, 2007 </a> <br> </td> <td> sirolimus-eluting stents<br>  <i>versus</i> <br> uncoated stents </td> <td> primary percutaneous coronary intervention for acute myocardial infarction with ST-segment elevation </td> <td> follow-up 1y<br> n=60/54<br> Parallel groups<br> open <br> Spain </td> </tr> <tr> <td> <a href="index.html"> Castaigne , 1989 </a> <br> </td> <td> anistreplase by mobile intensive care unit<br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=57/43<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> Roth, 1990 </a> <br> </td> <td> rt-PA by mobile intensive care unit<br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=72/44<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> Schofer, 1990 </a> <br> </td> <td> urokinase by mobile intensive care unit<br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=40/38<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> Barbash, 1990 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=-9/-9<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> Castaigne, 1987 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=-9/-9<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> Mcneill, 1989 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=-9/-9<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> Centre Illinois, 1993 </a> <br> </td> <td> t-PA 10 mg bolus, followed by 50 mg in the first hour, and 20 mg/hour for the next 2 hours<br>  <i>versus</i> <br> SK 375 000 IU bolus, followed by 1 125 000 IU/1 hage/pj </td> <td> patients with AMI within 3h from onset of chest pain </td> <td> follow-up <br> n=123/130<br> Parallel groups<br> single blind <br> USA </td> </tr> <tr> <td> <a href="index.html"> Cherng, 1992 </a> <br> </td> <td> 100 mg of rTPA over 3 hours (with early heparinization)<br>  <i>versus</i> <br> 1,500,000 units of streptokinase over 1 hour </td> <td> patients with acute myocardial infarction </td> <td> follow-up hospital stay<br> n=59/63<br> Parallel groups<br> open <br> Taiwan </td> </tr> <tr> <td> <a href="index.html"> ECSG, 1985 </a> <br> </td> <td> 0.75 mg rt-PA/kg over 90 min<br>  <i>versus</i> <br> 1 500 000 IU streptokinase over 60 min </td> <td> patients with acute myocardial infarction of less than 6 h duration </td> <td> follow-up <br> n=64/65<br> Parallel groups<br> single-blind <br> Europe </td> </tr> <tr> <td> <a href="index.html"> PAIMS, 1989 </a> <br> </td> <td> intravenous cumulative dose of 100 mg rt-PA<br>  <i>versus</i> <br> .5 million units streptokinase </td> <td> patients with acute myocardial infarction less than 3 h old </td> <td> follow-up <br> n=86/85<br> Parallel groups<br> open <br> Italy </td> </tr> <tr> <td> <a href="index.html"> TIMI-1, 1987 </a> <br> NCT00000505 </td> <td> rt-PA, 40, 20, and 20 mg in successive hours<br>  <i>versus</i> <br> SK 1.5 million units over 1 hr </td> <td> patients with evolving acute myocardial infarction within 7 hr of the onset of symptoms </td> <td> follow-up <br> n=157/159<br> Parallel groups<br> double blind <br> USA </td> </tr> <tr> <td> <a href="index.html"> White, 1989 </a> <br> </td> <td> rt-PA 100 mg over three hours<br>  <i>versus</i> <br> streptokinase 1.5 million units over 30 minutes </td> <td> patients with AMI </td> <td> follow-up <br> n=135/135<br> Parallel groups<br> double blind <br> New Zealand </td> </tr> <tr> <td> <a href="index.html"> KAMIT, 1991 </a> <br> </td> <td> half-dose (50 mg) t-PA with streptokinase (1.5 MU) during 1 hour<br>  <i>versus</i> <br> t-PA (100 mg) during 3 hours </td> <td> patients within 6 hours of myocardial infarction </td> <td> follow-up hospital stay<br> n=109/107<br> Parallel groups<br> open <br> USA </td> </tr> <tr> <td> <a href="index.html"> RAPID-2, 1996 </a> <br> </td> <td> 10 plus 10 megaunits double bolus of reteplase<br>  <i>versus</i> <br> front-loaded alteplase </td> <td> patients with acute myocardial infarction within 12h from onset of ischemic chest pain </td> <td> follow-up 35 days<br> n=169/155<br> Parallel groups<br> open <br> USA, Germany </td> </tr> <tr> <td> <a href="index.html"> LATE, 1993 </a> <br> </td> <td> intravenous alteplase (100 mg over 3 h)<br>  <i>versus</i> <br> placebo </td> <td> patients with symptoms and electrocardiographic criteria consistent with AMI between 6 and 24 h from symptom onset </td> <td> follow-up 6 mo<br> n=2836/2875<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> EMERAS (all delay), 1993 </a> <br> </td> <td> streptokinase 1.5 MU<br>  <i>versus</i> <br> placebo </td> <td> patients entering hospital up to 24 h after the onset of suspected acute myocardial infarction </td> <td> follow-up <br> n=2257/2277<br> Parallel groups<br> double blind <br> south america </td> </tr> <tr> <td> <a href="index.html"> USIM, 1991 </a> <br> </td> <td> urokinase bolus dose of 1 million U repeated after 60 minutes plus heparin<br>  <i>versus</i> <br> control (heparin alone) </td> <td> patients with acute myocardial infarction within 4 hours of the onset of pain </td> <td> follow-up in hospital<br> n=1128/1073<br> Parallel groups<br> open <br> Italy </td> </tr> <tr> <td> <a href="index.html"> ISIS 2 pilot, 1987 </a> <br> </td> <td> streptokinase 1.5 MU<br>  <i>versus</i> <br> placebo </td> <td> patients with suspected acute myocardial infarction </td> <td> follow-up <br> n=-9/-9<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> EMERAS (7-12h), 1993 </a> <br> </td> <td> intravenous streptokinase 1.5 MU<br>  <i>versus</i> <br> placebo </td> <td> patients presenting 7-12 h from symptom onset </td> <td> follow-up <br> n=2257/2277<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> PRIMI (vs UK), 1989 </a> <br> </td> <td> 20 mg bolus followed by 60 mg infusion for 60 min<br>  <i>versus</i> <br> 80 mg recombinant pro-urokinase </td> <td> with a first acute myocardial infarction within 4 h of onset of symptoms </td> <td> follow-up <br> n=198/-9<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> DANAMI-2, 1997 </a> <br> </td> <td> angioplasty<br>  <i>versus</i> <br> accelerated treatment with intravenous alteplase </td> <td> 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) </td> <td> follow-up 2.4y<br> n=-9/-9<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> CARESS, 2008 </a> <br> </td> <td> immediate transfer for PCI after half-dose reteplase, abciximab, heparin, and aspirin<br>  <i>versus</i> <br> half-dose reteplase, abciximab, heparin, and aspirin, transfer for PCI only if they had persistent ST elevation at 90 minutes (rescue PCI) </td> <td> STEMI patients under 75 years old within 12 hours of symptom onset who had been admitted to hospitals without PCI facilities </td> <td> follow-up 30 days<br> n=-9/-9<br> <br> open <br> France, Italy, and Poland </td> </tr> <tr> <td> <a href="index.html"> CAPITAL AMI, 2005 </a> <br> </td> <td> full-dose tenecteplase (TNK) plus PCI<br>  <i>versus</i> <br> thrombolysis alone </td> <td> high-risk MI patients within six hours of symptom onset </td> <td> follow-up 6 months<br> n=86/84<br> Parallel groups<br> open <br> US </td> </tr> <tr> <td> <a href="index.html"> DEDICATION, 2008 </a> <br> NCT00192868 </td> <td> DES currently used with or without distal protection <br>  <i>versus</i> <br> BMS with or without distal protection </td> <td> patients referred within 12 hours from symptom onset of an ST-elevation myocardial infarction </td> <td> follow-up 8 mo (15 mo, 3y)<br> n=313/313<br> Factorial plan<br> open <br> Denmark. </td> </tr> <tr> <td> <a href="index.html"> HORIZONS-AMI Stent, 2008 </a> <br> </td> <td> paclitaxel-eluting stents (Taxus)<br>  <i>versus</i> <br> BMS (Express) </td> <td> ST-elevation myocardial infarction </td> <td> follow-up 1 year<br> n=2257/749<br> Factorial plan<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> ZEST AMI (vs SES), 2009 </a> <br> NCT00422565 </td> <td> zotarolimus-eluting stent (Endeavor) <br>  <i>versus</i> <br> sirolimus-eluting stents (Cypher) </td> <td> Acute Myocardial Infarction Patients (STEMI)requiring primary angioplasty with symptom onset <= 12 hours </td> <td> follow-up 1 year (mean)<br> n=108/110<br> Parallel groups<br> open <br> Korea </td> </tr> <tr> <td> <a href="index.html"> WEST, 2006 </a> <br> </td> <td> TNK and mandatory invasive study <= 24 h, including rescue PCI for reperfusion failure<br>  <i>versus</i> <br> tenecteplase (TNK) and usual care </td> <td> STEMI patients (> 4 mm ST-elevation/deviation) within 6 h of symptom onse </td> <td> follow-up 30 days<br> n=104/100<br> Parallel groups<br> <br> Canada </td> </tr> <tr> <td> <a href="index.html"> CAPITAL AMI, 2005 </a> <br> </td> <td> TNK-facilitated angioplasty<br>  <i>versus</i> <br> TNK alone </td> <td> patients with high-risk ST-segment elevation myocardial infarction </td> <td> follow-up 6 months<br> n=86/84<br> Parallel groups<br> <br> </td> </tr> <tr> <td> <a href="index.html"> GRACIA-1, 2004 </a> <br> </td> <td> angiography and intervention if indicated within 24 h of thrombolysis<br>  <i>versus</i> <br> ischaemia-guided conservative approach </td> <td> patients with thrombolysed STEMI (with recombinant tissue plasminogen activator) </td> <td> follow-up 12 months<br> n=248/251<br> Parallel groups<br> <br> </td> </tr> <tr> <td> <a href="index.html"> SIAM III, 2002 </a> <br> </td> <td> immediate stenting after thrombolysis<br>  <i>versus</i> <br> conservative treatment </td> <td> patients receiving thrombolysis in AMI (<12 h) </td> <td> follow-up 6 months<br> n=82/81<br> Parallel groups<br> <br> Germany </td> </tr> <tr> <td> <a href="index.html"> PRAGUE, 2000 </a> <br> </td> <td> thrombolysis during immediate transportation for coronary angioplasty<br>  <i>versus</i> <br> thrombolysis in a community hospital </td> <td> patients with acute ST elevation myocardial infarction presenting to community hospitals </td> <td> follow-up 12 months<br> n=100/99<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> TIMI II-A (defered), 0 </a> <br> </td> <td> delayed invasive strategy, deferred angiography and PTCA for 18-48 hours<br>  <i>versus</i> <br> conservative approach </td> <td> </td> <td> follow-up <br> n=194/197<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> TAMI-5 (Califf), 1991 </a> <br> </td> <td> immediate catheterization with angioplasty for failed thrombolysis (90min after rtPA/urokinase)<br>  <i>versus</i> <br> deferred predischarge catheterization on days 5-10, no PTCA planned </td> <td> patient with acute myocardial infarction </td> <td> follow-up <br> n=287/288<br> Factorial plan<br> <br> </td> </tr> <tr> <td> <a href="index.html"> SHOCK (Hochman), 1999 </a> <br> NCT00000552 </td> <td> emergency revascularization<br>  <i>versus</i> <br> initial medical stabilization </td> <td> patients with cardiogenic shock complicating acute MI </td> <td> follow-up 30 days (6y)<br> n=152/150<br> Parallel groups<br> open <br> US </td> </tr> <tr> <td> <a href="index.html"> Ellis, 1994 </a> <br> </td> <td> balloon angioplasty supplemented by further thrombolytic therapy as needed<br>  <i>versus</i> <br> conservative therapy </td> <td> 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 </td> <td> follow-up <br> n=78/73<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> Vermeer, 1999 </a> <br> </td> <td> alteplase followed by transfer to the PTCA centre and (if indicated) rescue PTCA<br>  <i>versus</i> <br> thrombolytic treatment with alteplase </td> <td> patients with acute myocardial infarction initially admitted to a hospital without PTCA facilities </td> <td> follow-up 42 days<br> n=-9/-9<br> Parallel groups<br> <br> </td> </tr> <tr> <td> <a href="index.html"> Erbel, 1989 </a> <br> </td> <td> combined intravenous and intracoronary streptokinase with immediate coronary angioplasty<br>  <i>versus</i> <br> combined intravenous and intracoronary streptokinase without immediate coronary angioplasty </td> <td> patients with acute transmural myocardial infarction </td> <td> follow-up 3 years<br> n=103/103<br> Parallel groups<br> <br> </td> </tr> <tr> <td> <a href="index.html"> MERLIN (Sutton), 2004 </a> <br> </td> <td> emergency coronary angiography with rescue PCI<br>  <i>versus</i> <br> conservative treatment </td> <td> patients with STEMI and failed fibrinolysis </td> <td> follow-up 30 days<br> n=-9/-9<br> Parallel groups<br> <br> </td> </tr> <tr> <td> <a href="index.html"> SWISS-SMASH, 1999 </a> <br> </td> <td> emergency angiography, followed immediately by revascularization when indicated<br>  <i>versus</i> <br> initial medical management </td> <td> Patients with acute myocardial infarction and early shock </td> <td> follow-up 30 days (1y)<br> n=32/23<br> Parallel groups<br> open <br> Europe </td> </tr> <tr> <td> <a href="index.html"> FRESCO, 1998 </a> <br> </td> <td> elective stenting after successful primary PTCA<br>  <i>versus</i> <br> no further intervention after successful primary PTCA </td> <td> patient with successful primary PTCA </td> <td> follow-up 12 months<br> n=75/75<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> CADILLAC abciximab., 2002 </a> <br> </td> <td> stenting plus abciximab therapy<br>  <i>versus</i> <br> PTCA plus abciximab therapy </td> <td> patients with acute myocardial infarction </td> <td> follow-up 12 months<br> n=524/528<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> CADILLAC (no abciximab), 2002 </a> <br> </td> <td> stenting alone with the MultiLink stent<br>  <i>versus</i> <br> PTCA alone </td> <td> patients with acute myocardial infarction </td> <td> follow-up 12 months<br> n=512/518<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> ZWOLLE 6, 2005 </a> <br> </td> <td> stenting<br>  <i>versus</i> <br> balloon angioplasty </td> <td> unselected patients with STEMI </td> <td> follow-up 12 months<br> n=785/763<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> STOPAMI 3, 2004 </a> <br> </td> <td> coronary artery stenting<br>  <i>versus</i> <br> PTCA </td> <td> 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) </td> <td> follow-up 6 months<br> n=305/306<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> TIMI 2A, 1988 </a> <br> </td> <td> CA within 120 min of the start of the rtPA infusion. PTCA whether the artery is open or closed<br>  <i>versus</i> <br> CA within 18-48hrs. PTCA only if artery open (TIMI 2 or 3) </td> <td> patient thrombolyzed for a AMI </td> <td> follow-up 21 days<br> n=195/194<br> parallel group<br> open <br> USA </td> </tr> <tr> <td> <a href="index.html"> Belenkie, 1991 </a> <br> </td> <td> immediate PTCA<br>  <i>versus</i> <br> delayed PTCA (18-38h) </td> <td> patients with a patent infarct-related artery after thrombolytic therapy suitable for angioplasty </td> <td> follow-up 4 months<br> n=50/39<br> parallel group<br> open <br> Canada </td> </tr> <tr> <td> <a href="index.html"> Topol, 1987 </a> <br> </td> <td> immediate PTCA<br>  <i>versus</i> <br> no PTCA </td> <td> patients with evolving transmural myocardial infarction </td> <td> follow-up in hospital<br> n=15/13<br> parallel group<br> open <br> USA </td> </tr> <tr> <td> <a href="index.html"> TAMI 6, 1992 </a> <br> </td> <td> PTCA 6-24h after rtPA<br>  <i>versus</i> <br> no PTCA planned </td> <td> </td> <td> follow-up <br> n=34/37<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> Barbash, 1990 </a> <br> </td> <td> PTCA>72h after rtPA if stenosis>70%<br>  <i>versus</i> <br> PTCA>72h after rtPA if stenosis>50% and ischemia </td> <td> </td> <td> follow-up <br> n=97/104<br> <br> <br> </td> </tr> <tr> <td> <a href="index.html"> MAASTRICHT (Vermeer), 1999 </a> <br> </td> <td> Transfer for primary PTCA<br>  <i>versus</i> <br> immediate thrombolysis with tPA </td> <td> patients with acute myocardial infarction initially admitted to a hospital without PTCA facilities </td> <td> follow-up <br> n=75/75<br> <br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PRAGUE-1, 2000 </a> <br> </td> <td> immediate transportation for primary angioplasty without pre-treatment with thrombolysis<br>  <i>versus</i> <br> immediate thrombolysis with streptokinase </td> <td> patients with acute myocardial infarction, presenting within 6 h of symptom onset at community hospitals without a catheterization laboratory </td> <td> follow-up 30 days<br> n=101/99<br> <br> open <br> </td> </tr> <tr> <td> <a href="index.html"> AIR-PAMI, 2002 </a> <br> </td> <td> Transfer for Primary Angioplasty<br>  <i>versus</i> <br> immediate thrombolysis (various thrombolytic) </td> <td> 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 </td> <td> follow-up <br> n=71/66<br> <br> open <br> </td> </tr> <tr> <td> <a href="index.html"> CAPTIM, 2002 </a> <br> </td> <td> Transfer for Primary Angioplasty<br>  <i>versus</i> <br> prehospital fibrinolysis with accelerated alteplase </td> <td> patients within 6 h of acute myocardial infarction with ST-segment elevation, initially managed by mobile emergency-care units </td> <td> follow-up <br> n=421/419<br> <br> open <br> </td> </tr> <tr> <td> <a href="index.html"> DANAMI-2, 2003 </a> <br> </td> <td> Transfer for Primary Angioplasty<br>  <i>versus</i> <br> immediate thrombolysis with tPA (accelared infusion) </td> <td> patients with myocardial infarction with ST-segment elevation </td> <td> follow-up 30 days<br> n=567/562<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PRAGUE-2, 2003 </a> <br> </td> <td> immediate transport for primary percutaneous coronary intervention<br>  <i>versus</i> <br> immediate thrombolysis with streptokinase </td> <td> patients with acute ST elevation myocardial infarction presenting within <12 h to the nearest community hospital without a catheter laboratory </td> <td> follow-up 30 days<br> n=429/421<br> <br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PRAGUE-1 (thrombolysis+PTCA), 2000 </a> <br> </td> <td> thrombolytic therapy during transportation to angioplasty<br>  <i>versus</i> <br> immediate thrombolysis with streptokinase </td> <td> patients with acute myocardial infarction, presenting within 6 h of symptom onset at community hospitals without a catheterization laboratory </td> <td> follow-up 30 days<br> n=100/99<br> Parallel groups<br> open <br> Czech Republic </td> </tr> <tr> <td> <a href="index.html"> Zijlstra , 1993 </a> <br> </td> <td> immediate coronary angioplasty (without previous thrombolytic therapy)<br>  <i>versus</i> <br> intravenous streptokinase </td> <td> patients with acute myocardial infarction </td> <td> follow-up <br> n=70/72<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> Akhras, 1997 </a> <br> </td> <td> primary angioplasty<br>  <i>versus</i> <br> streptokinase </td> <td> patient within 12hr from onset of AMI </td> <td> follow-up <br> n=42/45<br> Parallel groups<br> open <br> Saudi Arabia </td> </tr> <tr> <td> <a href="index.html"> O'Neill, 1986 </a> <br> </td> <td> coronary angioplasty<br>  <i>versus</i> <br> intracoronary streptokinase </td> <td> patients within 12 hours of their first symptoms of acute myocardial infarction </td> <td> follow-up <br> n=-9/-9<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> AIR-PAMI , 2002 </a> <br> </td> <td> Transfer for Primary Angioplasty<br>  <i>versus</i> <br> immediate thrombolysis (various thrombolytic) </td> <td> 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 </td> <td> follow-up <br> n=71/66<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> DANAMI-2 , 2003 </a> <br> </td> <td> Transfer for Primary Angioplasty<br>  <i>versus</i> <br> immediate thrombolysis with tPA (accelared infusion) </td> <td> patients with myocardial infarction with ST-segment elevation </td> <td> follow-up 30 days<br> n=567/562<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PRAGUE-2 , 2003 </a> <br> </td> <td> immediate transport for primary percutaneous coronary intervention<br>  <i>versus</i> <br> immediate thrombolysis with streptokinase </td> <td> patients with acute ST elevation myocardial infarction presenting within <12 h to the nearest community hospital without a catheter laboratory </td> <td> follow-up 30 days<br> n=429/421<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> STAT, 2001 </a> <br> </td> <td> primary stenting<br>  <i>versus</i> <br> accelerated t-PA </td> <td> patients with acute ST-elevation myocardial infarction </td> <td> follow-up 6 months<br> n=62/61<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> STOPAMI 1, 2000 </a> <br> </td> <td> stent plus abciximab<br>  <i>versus</i> <br> intravenous alteplase </td> <td> patients with acute myocardial infarction </td> <td> follow-up 6 months<br> n=71/69<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> C-PORT, 2002 </a> <br> </td> <td> primary PCI without on-site cardiac surgery<br>  <i>versus</i> <br> accelerated tissue plasminogen activator </td> <td> thrombolytic-eligible patients with acute MI of less than 12 hours' duration associated with ST-segment elevation </td> <td> follow-up 6 months<br> n=225/226<br> Parallel groups<br> open <br> USA </td> </tr> <tr> <td> <a href="index.html"> STOPAMI 2, 2002 </a> <br> </td> <td> stenting combined with abciximab<br>  <i>versus</i> <br> fibrinolysis by alteplase combined with abciximab </td> <td> patients with acute myocardial infarction within 12 h of onset of symptoms </td> <td> follow-up <br> n=81/81<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> APSIM, 1989 </a> <br> </td> <td> APSAC 30 U over 5 min<br>  <i>versus</i> <br> control (conventional heparin therapy, 5,000 IU in a bolus injection) </td> <td> patients with a first acute myocardial infarction within 5 h after the onset of symptoms </td> <td> follow-up 3 weeks<br> n=112/119<br> Parallel groups<br> open <br> France </td> </tr> <tr> <td> <a href="index.html"> TAMI 6, 1992 </a> <br> </td> <td> tissue-type plasminogen activator 100 mg over 2 hours<br>  <i>versus</i> <br> placebo </td> <td> patients with 6 to 24 hours of symptoms and ECG ST elevation </td> <td> follow-up 6 months<br> n=96/101<br> Parallel groups<br> double blind <br> USA </td> </tr> <tr> <td> <a href="index.html"> TAMI 5 (t-PA vs uroK), 1991 </a> <br> </td> <td> accelerated t-PA 100mg over 3h<br>  <i>versus</i> <br> urokinase IV bolus 1.5 MU followed by 1.5 MU over 90min </td> <td> patient with acute myocardial infarction </td> <td> follow-up <br> n=191/190<br> <br> open <br> </td> </tr> <tr> <td> <a href="index.html"> TEAM 2, 1991 </a> <br> </td> <td> anistreplase (30 units/2-5 min)<br>  <i>versus</i> <br> streptokinase (1.5 million units/60 min </td> <td> less than 76 years of age with electrocardiographic ST segment elevation who could be treated within 4 hours of symptom onset </td> <td> follow-up <br> n=183/176<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> TEAM 3, 1992 </a> <br> </td> <td> APSAC, 30 U/2 to 5 min<br>  <i>versus</i> <br> rt-PA, 100 mg/3 h, </td> <td> patient with ST elevalation within 4h of the onset of symptoms </td> <td> follow-up 1 months<br> n=325/0<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> TAPS, 1992 </a> <br> </td> <td> front-loaded administration of rt-PA<br>  <i>versus</i> <br> APSAC </td> <td> patients with acute myocardial infarction. </td> <td> follow-up <br> n=199/202<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> RAAMI, 1992 </a> <br> </td> <td> 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)<br>  <i>versus</i> <br> 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 </td> <td> patients with acute myocardial infarction within 6h from onset of chest pain </td> <td> follow-up hospital stay<br> n=143/138<br> Parallel groups<br> open <br> US </td> </tr> <tr> <td> <a href="index.html"> TIMI 4, 1994 </a> <br> </td> <td> front-loaded rt-PA<br>  <i>versus</i> <br> APSAC </td> <td> patients with acute myocardial infarction </td> <td> follow-up hospital stay<br> n=-9/-9<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="index.html"> TAMI 5 (t-PA+uroK vs tPA), 1991 </a> <br> </td> <td> t-PA + urokinase<br>  <i>versus</i> <br> t-PA </td> <td> patient with acute myocardial infarction </td> <td> follow-up <br> n=194/191<br> <br> open <br> </td> </tr> <tr> <td> <a href="index.html"> STAR, 1995 </a> <br> </td> <td> recombinant staphylokinase (10 or 20 mg given intravenously over 30 minutes)<br>  <i>versus</i> <br> weight-adjusted rt-PA over 90 minutes </td> <td> patients with evolving myocardial infarction of < 6 hours' duration and with ST-segment elevation </td> <td> follow-up 90 min<br> n=48/52<br> Parallel groups<br> open <br> Belgium </td> </tr> <tr> <td> <a href="index.html"> senior PAMI, 2005 </a> <br> NCT00136929 </td> <td> primary percutaneous coronary intervention<br>  <i>versus</i> <br> intravenous thrombolytic therapy </td> <td> elderly (age >= 70 years) patients with acute myocardial infarction </td> <td> follow-up 30 days<br> n=252/229<br> Parallel groups<br> Open <br> </td> </tr> <tr> <td> <a href="index.html"> NORDISTEMI, 2009 </a> <br> NCT00161005 </td> <td> transfer for immediate coronary angiography and intervention<br>  <i>versus</i> <br> concervative strategy </td> <td> patients with STEMI of less than 6 hours of duration and more than 90 minutes expected time delay to PCI </td> <td> follow-up 1y<br> n=134/132<br> Parallel groups<br> open <br> Norway </td> </tr> <tr> <td> <a href="index.html"> TRIANA, 2009 </a> <br> NCT00257309 </td> <td> Tenecteplase + UFH (+/- clopidogrel)<br>  <i>versus</i> <br> Primary angioplasty </td> <td> >=75 years old with ST-segment elevation or LBBB AMI <6 hours of evolution without contraindications for thrombolytic therapy </td> <td> follow-up 30 days (12 months)<br> n=132/134<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> PASEO, 2009 </a> <br> </td> <td> paclitaxel-eluting stents and sirolimus-eluting stents<br>  <i>versus</i> <br> bare metal stent </td> <td> patients with ST-elevation myocardial infarction within 12 hours from symptom onset </td> <td> follow-up 4.3 years<br> n=180/90<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="index.html"> Juwana, 2009 </a> <br> ISRCTN90526229 </td> <td> sirolimus coated Cypher stent<br>  <i>versus</i> <br> paclitaxel coated Taxus stent </td> <td> patients with STEMI undergoing primary PCI </td> <td> follow-up 9 months (12 months)<br> n=196/201<br> Parallel groups<br> open <br> The Netherlands </td> </tr> <tr> <td> <a href="index.html"> TRANSFER-AMI, 2008 </a> <br> NCT00164190 </td> <td> pharmacoinvasive strategy (transfer for PCI within six hours of fibrinolysis)<br>  <i>versus</i> <br> standard treatment after fibrinolysis (rescue PCI for failed reperfusion, with elective PCI encouraged for successfully reperfused patients after 24 hours) </td> <td> patients with high-risk STEMI </td> <td> follow-up 30 days<br> n=-9/-9<br> Parallel groups<br> open <br> </td> </tr> </table> <h2>References</h2> <p> <b>Zwolle, 1994 : </b> de Boer MJ, Hoorntje JC, Ottervanger JP, Reiffers S, Suryapranata H, Zijlstra FImmediate coronary angioplasty versus intravenous streptokinase in acute myocardial infarction: left ventricular ejection fraction, hospital mortality and reinfarction. <i>J Am Coll Cardiol 1994;23:1004-8</i> [PMID 8144761] </p> <p> <b>Ribeiro, 1993 : </b> Ribeiro EE, Silva LA, Carneiro R, D'Oliveira LG, Gasquez A, Amino JG, Tavares JR, Petrizzo A, Torossian S, Duprat Filho RRandomized trial of direct coronary angioplasty versus intravenous streptokinase in acute myocardial infarction. <i>J Am Coll Cardiol 1993;22:376-80</i> [PMID 8335807] </p> <p> <b>Grinfeld, 1996 : </b> Grinfeld L et al.abstract <i>JACC 1996;27:222A</i> [PMID ] </p> <p> <b>Zijlstra, 1997 : </b> Zijlstra F, Beukema WP, van 't Hof AW, Liem A, Reiffers S, Hoorntje JC, Suryapranata H, de Boer MJRandomized comparison of primary coronary angioplasty with thrombolytic therapy in low risk patients with acute myocardial infarction. <i>J Am Coll Cardiol 1997;29:908-12</i> [PMID 9120174] </p> <p> <b>DeWood, 1989 : </b> DeWood MA, Fisher MJ for the spokane Heart Research Group <i>Circulation 1989; 80(suppl 2):II418</i> [PMID ] </p> <p> <b>PAMI, 1993 : </b> Grines CL, Browne KF, Marco J, Rothbaum D, Stone GW, O'Keefe J, Overlie P, Donohue B, Chelliah N, Timmis GCA comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction. 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The Mayo Coronary Care Unit and Catheterization Laboratory Groups. <i>N Engl J Med 1993;328:685-91</i> [PMID 8433727] </p> <p> <b>Ribichini, 1996 : </b> <i> JACC 1996; 211A</i> [PMID 0] </p> <p> <b>Garcia, 1997 : </b> Garc�a E, El�zaga J, P�rez-Castellano N, Serrano JA, Soriano J, Abeytua M, Botas J, Rubio R, L�pez de S� E, L�pez-Send�n JL, Delc�n JLPrimary angioplasty versus systemic thrombolysis in anterior myocardial infarction. <i>J Am Coll Cardiol 1999;33:605-11</i> [PMID 10080458] </p> <p> <b>GUSTO 2B, 1997 : </b> A clinical trial comparing primary coronary angioplasty with tissue plasminogen activator for acute myocardial infarction. The Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) Angioplasty Substudy Investigators. <i>N Engl J Med 1997;336:1621-8</i> [PMID 9173270] </p> <p> <b>GUSTO tPA Hiv, 1993 : </b> An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. The GUSTO investigators. <i>N Engl J Med 1993 Sep 2;329:673-82</i> [PMID 8204123] </p> <p> <b>ISAM, 1986 : </b> A prospective trial of intravenous streptokinase in acute myocardial infarction (I.S.A.M.). Mortality, morbidity, and infarct size at 21 days. The I.S.A.M. Study Group. <i>N Engl J Med 1986 Jun 5;314:1465-71</i> [PMID 2871492] </p> <p> <b>AIMS, 1988 : </b> Effect of intravenous APSAC on mortality after acute myocardial infarction: preliminary report of a placebo-controlled clinical trial. AIMS Trial Study Group. <i>Lancet 1988 Mar 12;1:545-9</i> [PMID 2894490] </p> <p> <b>AIMS, 1988 : </b> Long-term effects of intravenous anistreplase in acute myocardial infarction: final report of the AIMS study. AIMS Trial Study Group. <i>Lancet 1990 Feb 24;335:427-31</i> [PMID 1968167] </p> <p> <b>ISIS-2 (SK), 1988 : </b> Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. 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The International Study Group. <i>Lancet 1990;336:71-5</i> [PMID 1975322] </p> <p> <b>GISSI I, 1986 : </b> Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico (GISSI). <i>Lancet 1986 Feb 22;1:397-402</i> [PMID 2868337] </p> <p> <b>GISSI I, 1986 : </b> Long-term effects of intravenous thrombolysis in acute myocardial infarction: final report of the GISSI study. Gruppo Italiano per lo Studio della Streptochi-nasi nell'Infarto Miocardico (GISSI). <i>Lancet 1987 Oct 17;2:871-4</i> [PMID 2889079] </p> <p> <b>ISIS III (SK/APSAC), 1992 : </b> ISIS-3: a randomised comparison of streptokinase vs tissue plasminogen activator vs anistreplase and of aspirin plus heparin vs aspirin alone among 41,299 cases of suspected acute myocardial infarction. ISIS-3 (Third International Study of Infarct Survival) Collaborative Group. <i>Lancet 1992;339:753-70</i> [PMID 1347801] </p> <p> <b>COMPASS, 1998 : </b> Tebbe U, Michels R, Adgey J, Boland J, Caspi A, Charbonnier B, Windeler J, Barth H, Groves R, Hopkins GR, Fennell W, Betriu A, Ruda M, Mlczoch JRandomized, double-blind study comparing saruplase with streptokinase therapy in acute myocardial infarction: the COMPASS Equivalence Trial. Comparison Trial of Saruplase and Streptokinase (COMASS) Investigators <i>J Am Coll Cardiol 1998;31:487-93</i> [PMID 9502624] </p> <p> <b>GUSTO tPA-SK Hiv, 1993 : </b> An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. The GUSTO investigators. <i>N Engl J Med 1993 Sep 2;329:673-82</i> [PMID 8204123] </p> <p> <b>GUSTO III, 1997 : </b> A comparison of reteplase with alteplase for acute myocardial infarction. The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO III) Investigators. <i>N Engl J Med 1997 Oct 16;337:1118-23</i> [PMID 9340503] </p> <p> <b>GUSTO III, 1997 : </b> A comparison of reteplase with alteplase for acute myocardial infarction. The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO III) Investigators. <i>N Engl J Med 1997;337:1118-23</i> [PMID 9340503] </p> <p> <b>INJECT, 1995 : </b> Randomised, double-blind comparison of reteplase double-bolus administration with streptokinase in acute myocardial infarction (INJECT): trial to investigate equivalence. International Joint Efficacy Comparison of Thrombolytics <i>Lancet 1995;346:329-36</i> [PMID 7623530] </p> <p> <b>PRIMI (vs SK), 1989 : </b> Randomised double-blind trial of recombinant pro-urokinase against streptokinase in acute myocardial infarction. PRIMI Trial Study Group <i>Lancet 1989;1:863-8</i> [PMID 2564949] </p> <p> <b>Mathey, 1985 : </b> Mathey DG, Schofer J, Sheehan FH, Becher H, Tilsner V, Dodge HTIntravenous urokinase in acute myocardial infarction <i>Am J Cardiol 1985;55:878-82</i> [PMID 3984876] </p> <p> <b>SESAM, 1997 : </b> B�r FW, Meyer J, Vermeer F, Michels R, Charbonnier B, Haerten K, Spiecker M, Macaya C, Hanssen M, Heras M, Boland JP, Morice MC, Dunn FG, Uebis R, Hamm C, Ayzenberg O, Strupp G, Withagen AJ, Klein W, Windeler J, Hopkins G, Barth H, von Fisenne MJComparison of saruplase and alteplase in acute myocardial infarction. SESAM Study Group. The Study in Europe with Saruplase and Alteplase in Myocardial Infarction. <i>Am J Cardiol 1997 Mar 15;79:727-32</i> [PMID 9070549] </p> <p> <b>COBALT, 1997 : </b> A comparison of continuous infusion of alteplase with double-bolus administration for acute myocardial infarction. 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ISIS-3 (Third International Study of Infarct Survival) Collaborative Group. <i>Lancet 1992 Mar 28;339:753-70</i> [PMID 1347801] </p> <p> <b>TEAHAT, 1990 : </b> Very early thrombolytic therapy in suspected acute myocardial infarction. The Thrombolysis Early in Acute Heart Attack Trial Study Group. <i>Am J Cardiol 1990;65:401-7</i> [PMID 2106252] </p> <p> <b>MITI, 1993 : </b> Weaver WD, Cerqueira M, Hallstrom AP, Litwin PE, Martin JS, Kudenchuk PJ, Eisenberg MPrehospital-initiated vs hospital-initiated thrombolytic therapy. The Myocardial Infarction Triage and Intervention Trial. <i>JAMA 1993;270:1211-6</i> [PMID 8355383] </p> <p> <b>GREAT, 1994 : </b> Rawles J,Halving of mortality at 1 year by domiciliary thrombolysis in the Grampian Region Early Anistreplase Trial (GREAT). <i>J Am Coll Cardiol 1994; 23:1-5</i> [PMID 8277066] </p> <p> <b>GREAT, 1994 : </b> Feasibility, safety, and efficacy of domiciliary thrombolysis by general practitioners: Grampian region early anistreplase trial. GREAT Group. <i>BMJ 1992;305:548-53</i> [PMID 1393033] </p> <p> <b>EMIP, 1993 : </b> ,Prehospital thrombolytic therapy in patients with suspected acute myocardial infarction. The European Myocardial Infarction Project Group. <i>N Engl J Med 1993; 329:383-9</i> [PMID 8326971] </p> <p> <b>TAMI 1 pilot, 1987 : </b> Topol EJ, Califf RM, George BS, Kereiakes DJ, Abbottsmith CW, Candela RJ, Lee KL, Pitt B, Stack RS, O'Neill WWA randomized trial of immediate versus delayed elective angioplasty after intravenous tissue plasminogen activator in acute myocardial infarction. <i>N Engl J Med 1987 Sep 3;317:581-8</i> [PMID 2956516] </p> <p> <b>ECSG, 1988 : </b> Simoons ML, Arnold AE, Betriu A, de Bono DP, Col J, Dougherty FC, von Essen R, Lambertz H, Lubsen J, Meier B, et al,Thrombolysis with tissue plasminogen activator in acute myocardial infarction: no additional benefit from immediate percutaneous coronary angioplasty. <i>Lancet 1988; 1:197-203</i> [PMID 2893037] </p> <p> <b>ECSG, 1988 : </b> Arnold AE, Simoons ML, Van de Werf F, de Bono DP, Lubsen J, Tijssen JG, Serruys PW, Verstraete MRecombinant tissue-type plasminogen activator and immediate angioplasty in acute myocardial infarction. One-year follow-up. The European Cooperative Study Group. <i>Circulation 1992 Jul;86:111-20</i> [PMID 1617763] </p> <p> <b>SWIFT, 1991 : </b> ,SWIFT trial of delayed elective intervention v conservative treatment after thrombolysis with anistreplase in acute myocardial infarction. SWIFT (Should We Intervene Following Thrombolysis?) Trial Study Group. <i>BMJ 1991; 302:555-60</i> [PMID 2021717] </p> <p> <b>SIAM, 1992 : </b> <i>JACC 1992 19:239A(abstract)</i> [PMID 0] </p> <p> <b>TIMI 2, 1989 : </b> ,Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) phase II trial. 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