Title

Comparison Between Thrombolysis and Primary Percutaneous Coronary Intervention (PCI) to Treat ST-Segment Elevation Myocardial Infarction
Very Early Initiation of Treatment With Thrombolysis and Low Molecular Weight Heparin, Versus Abciximab and Low Molecular Weight Heparin Followed by Percutaneous Coronary Intervention, for Acute ST-Elevation Myocardial Infarction
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Intervention/Treatment

    reteplase ...
  • Study Participants

    205
The main objective is to compare a fibrinolytic strategy with an interventional strategy initiated as early as possible, preferably in the pre-hospital phase, with respect to resolution of ST-segment elevation at 120 minutes after inclusion and Thrombolysis In Myocardial Infarction (TIMI) flow grade evaluated at a mandated coronary angiography 5 to 7 days after inclusion.
Patients in the fibrinolytic group received an intravenous injection of 30 mg enoxaparin followed by subcutaneous injections of 1 mg/kg body weight every 12 hours during hospital stay.

Patients in the invasive group were given an intravenous injection of enoxaparin of (0.75 mg/kg body weight) and abciximab as a intravenous bolus (0.25 mg/kg body weight) followed by a 12 hour infusion (10 microg/minute).

Secondary outcome measures were death, myocardial infarction and stroke alone or as a composite at 30 days.

Data on use of health care resources, loss of production and health-related quality of life were collected during one year. Cost-effectiveness was determined by comparing costs and quality-adjusted survival.
Study Started
Nov 30
2001
Primary Completion
Jun 30
2003
Study Completion
Jun 30
2004
Results Posted
Dec 10
2008
Estimate
Last Update
Dec 10
2008
Estimate

Drug reteplase 10+10 U

comparison to primary PCI

  • Other names: Rapilysin

Procedure primary PCI

comparison to thrombolysis

  • Other names: primary percutaneous coronary intervention

thrombolysis Active Comparator

invasive Active Comparator

Criteria

Inclusion Criteria:

Patients presenting within 6 h after onset of chest pain lasting for more than 30 min and with significant ST-segment elevation on ECG.

Exclusion Criteria:

BP >180/110
Known bleeding disorder
Cardiogenic shock
CPR>10 min
Ongoing anticoagulant therapy
Renal insufficiency
Weight >120 kg

Summary

All Events

Event Type Organ System Event Term

Number of Patients With ST-segment Elevation Resolution Equal or More Than 50%

ST-segment elevation resolution was measured in the lead with most prominent ST elevation at time of inclusion

Thrombolysis

47.0
participants

Invasive

51.0
participants

Number of Patients With Thrombolysis In Myocardial Infarction (TIMI) Flow Grade 3

Thrombolysis In Myocardial Infarction (TIMI) flow grade in the infarct related artery 5-7 days after inclusion.

Thrombolysis

35.0
participants

Invasive

56.0
participants

Death

Thrombolysis

4.0
participants

Invasive

3.0
participants

Reinfarction

Thrombolysis

2.0
Participants

Invasive

Stroke

Thrombolysis

3.0
Participants

Invasive

Total

205
Participants

Age Continuous

64.8
years (Mean)
Standard Deviation: 11.7

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Thrombolysis

Invasive

Drop/Withdrawal Reasons

Thrombolysis

Invasive