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(Circulation. 1997;96:367-371.)
© 1997 American Heart Association, Inc.

Articles

Meeting Highlights

46th Annual Scientific Sessions of the American College of Cardiology

James J. Ferguson, MD

From St Luke's Episcopal Hospital/Texas Heart Institute, Baylor College of Medicine, and the University of Texas Health Science Center at Houston.

Correspondence to James J. Ferguson, MD, Cardiology Research, 1-191, Texas Heart Institute, PO Box 20345, Houston, TX 77225.

	Introduction

 
The following studies were presented at the 46th Annual Scientific Sessions of the American College of Cardiology, March 16-19, 1997, Anaheim, Calif.

	GUSTO III

 
Dr Eric Topol, Cleveland Clinic, Cleveland, Ohio, presented the third Global Use of STrategies to Open occluded coronary arteries (GUSTO III) study. This was a randomized trial that compared recombinant plasminogen activator (RPA) with accelerated tissue plaminogen activator (TPA) in patients within 6 hours of an acute myocardial infarction (MI). Between November 1996 and January 1997, a total of 15 060 patients were enrolled at 880 hospitals in 20 countries. Qualifying patients were randomized in a 2:1 fashion to RPA (two 10-µm boluses 30 minutes apart) or TPA (90-minute accelerated regimen). Patients were treated with adjunctive aspirin (150 to 325 mg/d) and intravenous heparin. The primary end point of the study was all-cause mortality at 30 days. Of the total population enrolled, 13.5% were >75 years of age and 27.5% were women.

With regard to the primary end point of the trial, 30-day mortality in the RPA group was 7.43%, versus 7.2% in the TPA group (P=.63). There also were no significant differences between the RPA and TPA groups in 24-hour (2.99% versus 2.67%) or in-hospital mortality rates (6.96% versus 6.25%). The incidence of severe bleeding complications was similar between groups (0.72% with RPA versus 0.82% with TPA). In the RPA group, the incidence of hemorrhagic stroke was 0.91% (versus 0.88% with TPA), the incidence of nonhemorrhagic stroke was 0.61% (versus 0.73% with TPA), and the . . . [Full Text of this Article]

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