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Systematic review and meta-analysis

This trial is included in the following systematic reviews and meta-analyses:

acute myocardial infarction - myocardial revascularization - all type of patients

acute myocardial infarction - PCI - all type of patients


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See also:

  • All acute myocardial infarction clinical trials
  • All clinical trials of PCI
  • All clinical trials of thrombolysis + angioplasty
    		•  

    CAPITAL AMI study, 2005

    Facebook    pdf : thrombolysis + angioplasty - myocardial revascularization for acute myocardial infarction

    Treatments

    Studied treatment full-dose tenecteplase (TNK) plus PCI
    thrombolysis with full-dose TNK followed by immediate transfer for angiography and possible PCI
    Control treatment thrombolysis alone

    Patients

    Patients high-risk MI patients within six hours of symptom onset

    Method and design

    Randomized effectives 86 / 84 (studied vs. control)
    Design Parallel groups
    Blinding open
    Follow-up duration 6 months
    Number of centre 4
    Geographic area US


    Results



    Endpoints and data reported in the trial's publication(s)

    Endpoint Events (%) Relative Risk 95% CI
    Studied treat. Control treat.
    In-hospital Death 2 / 86 (2,3%) 3 / 84 (3,6%) 0,65 [0,11;3,80]
    In-hospital Reinfarction 3 / 86 (3,5%) 11 / 84 (13,1%) 0,27 [0,08;0,92]
    In-hospital Recurrent unstable ischemia� 5 / 86 (5,8%) 15 / 84 (17,9%) 0,33 [0,12;0,86]
    In-hospital Stroke 1 / 86 (1,2%) 1 / 84 (1,2%) 0,98 [0,06;15,36]
    In-hospital Death, reinfarction, or stroke 5 / 86 (5,8%) 14 / 84 (16,7%) 0,35 [0,13;0,93]
    In-hospital Primary end point 7 / 86 (8,1%) 18 / 84 (21,4%) 0,38 [0,17;0,86]
    Death At 30 days 2 / 86 (2,3%) 3 / 84 (3,6%) 0,65 [0,11;3,80]
    Reinfarction At 30 days 4 / 86 (4,7%) 11 / 84 (13,1%) 0,36 [0,12;1,07]
    Recurrent unstable ischemia At 30 days 6 / 86 (7,0%) 15 / 84 (17,9%) 0,39 [0,16;0,96]
    Stroke At 30 days 1 / 86 (1,2%) 1 / 84 (1,2%) 0,98 [0,06;15,36]
    Death, reinfarction, or stroke At 30 days 6 / 86 (7,0%) 14 / 84 (16,7%) 0,42 [0,17;1,04]
    Primary end point At 30 days 8 / 86 (9,3%) 18 / 84 (21,4%) 0,43 [0,20;0,94]
    Death At 6 months 3 / 86 (3,5%) 3 / 84 (3,6%) 0,98 [0,20;4,70]
    Reinfarction At 6 months 5 / 86 (5,8%) 12 / 84 (14,3%) 0,41 [0,15;1,11]
    Recurrent unstable ischemia At 6 months 7 / 86 (8,1%) 17 / 84 (20,2%) 0,40 [0,18;0,92]
    Stroke At 6 months 1 / 86 (1,2%) 1 / 84 (1,2%) 0,98 [0,06;15,36]
    Death, reinfarction, or stroke At 6 months 8 / 86 (9,3%) 15 / 84 (17,9%) 0,52 [0,23;1,16]
    Primary end point At 6 months 10 / 86 (11,6%) 20 / 84 (23,8%) 0,49 [0,24;0,98]

    Endpoints used by the meta-analysis and data retained for this trial

    Endpoint Studied treat.
    n/N     Control treat.
    n/N     Graph RR [95% CI]

    stroke (fatal and non fatal)

    1 / 86
         1 / 84
         classic 0,98 [0,06;15,36]

    reinfarction

    5 / 86
         12 / 84
         0,41 [0,15;1,11]

    death, reinfarctus, stroke

    8 / 86
         15 / 84
         0,52 [0,23;1,16]

    All cause death

    3 / 86
         3 / 84
         classic 0,98 [0,20;4,70]

    recurrent angina

    7 / 86
         17 / 84
         0,40 [0,18;0,92]     0 2 1.0

    Relative risks
    Endpoint Events (%) Relative Risk 95% CI Endpoint definition
    in the trial    		 Ref
    Studied treat. Control treat.
    stroke (fatal and non fatal) 1 / 86 (1,2%) 1 / 84 (1,2%) 0,98 [0,06;15,36] Stroke At 6 months   0 
    reinfarction 5 / 86 (5,8%) 12 / 84 (14,3%) 0,41 [0,15;1,11] Reinfarction At 6 months   0 
    death, reinfarctus, stroke 8 / 86 (9,3%) 15 / 84 (17,9%) 0,52 [0,23;1,16] Death, reinfarction, or stroke At 6 months   0 
    All cause death 3 / 86 (3,5%) 3 / 84 (3,6%) 0,98 [0,20;4,70] Death At 6 months   0 
    recurrent angina 7 / 86 (8,1%) 17 / 84 (20,2%) 0,40 [0,18;0,92] Recurrent unstable ischemia At 6 months   0 
    The primary endpoint (if exists) appears in blod characters
    Reference(s) used for data extraction:
  • 0:

    • Endpoint studied treat. control treat. mean diff

    Absolute risk reduction
    Endpoint Events rate Absolute risk
    reduction (ARR)
    Studied treat. Control treat.
    stroke (fatal and non fatal) 1,16% 1,19% -0,3‰
    reinfarction 5,81% 14,29% -84,7‰
    death, reinfarctus, stroke 9,30% 17,86% -85,5‰
    All cause death 3,49% 3,57% -0,8‰
    recurrent angina 8,14% 20,24% -121,0‰

    Meta-analysis of all similar trials:

    myocardial revascularization in acute myocardial infarction for all type of patients

    PCI in acute myocardial infarction for all type of patients



    Reference(s)

    Trials register # NA
    • Le May MR, Wells GA, Labinaz M, Davies RF, Turek M, Leddy D, Maloney J, McKibbin T, Quinn B, Beanlands RS, Glover C, Marquis JF, O'Brien ER, Williams WL, Higginson LA. Combined angioplasty and pharmacological intervention versus thrombolysis alone in acute myocardial infarction (CAPITAL AMI study).. J Am Coll Cardiol 2005 Aug 2;46:417-24
      Pubmed | Hubmed | Fulltext

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