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1、CombinedAngioplastyandPharmacologicalInterventionVersusThrombolyticsAloneinAcuteMyocardialInfarctionPresentedatAmericanCollegeofCardiologyScientificSessions2004PresentedbyDr.MichelR.LeMayCAPITALAMITrialEndpoints(30daysand6months):Compositeofdeath,reinfarction,recurrentunstableischemia,orstrokeCAP
2、ITALAMITrialPresentedatACCScientificSessions2004170patientspresentingwithSTelevationacuteMIwithchestpain≥30minutesandwithinsixhoursofsymptomonsetRandomized,open-label,multicenterThrombolyticTherapyFull-doseTenectaplase(TNK)n=84ThrombolyticTherapy,Transfer,andPCIFull-doseTenectaplase(TNK)followedb
3、ytransferandsubsequentpercutaneouscoronaryintervention(PCI)n=86In-HospitalCompositeEventRatep=0.017PresentedatACCScientificSessions2004CAPITALAMITrial%Thecompositein-hospitaleventrateofdeath,reinfarction,recurrentunstableischemia,orstrokewaslowerintheTNK+PCIarmcomparedwiththeTNKalonearm,drivenbya
4、reductioninreinfarctionandrecurrentunstableischemia.TNKTNK+PCITNKTNK+PCIIn-HospitalReinfarctionp=0.046In-HospitalRecurrentUnstableIschemiap=0.02PresentedatACCScientificSessions2004CAPITALAMITrial%PCIwasperformedin91%ofpatientsinthecombinationtherapyarm.IntheTNKalonearm,47%ofpatientsunderwentPCIdu
5、ringtheindexhospitalization.AnteriorMIlocationwaspresentin49%intheTNKalonearmand52%intheTNK+PCIarm.TherewasnodifferenceinTIMImajorbleedorejectionfraction(EF)atday7orday30.TNKTNK+PCITNKTNK+PCITNKTNK+PCITIMIMajorBleedp=NSEFatDay7p=NSEFatDay30p=NSPrimaryCompositeEndpointat30daysp=0.034PresentedatACC
6、ScientificSessions2004CAPITALAMITrial%CompositeeventrateremainedlowerintheTNK+PCIarmat30days,againdrivenbyreductionsinreinfarctionandrecurrentunstableischemia,withnodifferenceinmortality(2.3%vs.3.6%).LengthofhospitalstayshorterintheTNK+PCIarm(5vs.6days,p=0.009).TNKTNK+PCITNKTNK+PCI30-DayReinfarct
7、ion30-DayRecurrentUnstableIschemiaAmongpatientswithSTEMI,treatmentwithfull-doseTNKwithtransferforPCIwasassociatedwithalowerrateofthecompositeofdeath,reinfarction,recurrentunstableischemia,orstrokeat30dayscomparedwithTN
