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(Circulation. 1998;97:2377-2381.)
© 1998 American Heart Association, Inc.

Cardiovascular News

Meeting Highlights

47th 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, The University of Texas Health Science Center at Houston.

The following studies were presented at the 47th Annual Scientific Sessions of the American College of Cardiology in Atlanta, Ga, March 29–April 1, 1998.

Acute Coronary Syndromes

TIMI 14 (Final Results)
Presenter: Elliott Antman, MD, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass.

The study: A prospective, multicenter, randomized, controlled trial of combined therapy with thrombolytic agents and the platelet glycoprotein IIb/IIIa antagonist abciximab in patients with AMI. A total of 681 patients were randomized to standard front-loaded tPA (100 mg), streptokinase (500 000, 750 000, 1 250 000, or 1 500 000 U) plus abciximab, low-dose tPA (20, 35, 50, or 65 mg) plus abciximab, or abciximab alone. In the streptokinase groups, lytic therapy was administered as a 30- to 50-minute infusion. In the tPA groups, lytic therapy was administered as either a bolus, a bolus plus a 30-minute infusion, or a bolus plus a 60-minute infusion. The primary end point of the study was the incidence of TIMI grade 3 flow at 90-minute angiography.

The results: The incidence of TIMI 3 flow at 90 minutes was 58% in the tPA-alone arm (n=146), 32% in the abciximab-alone arm (n=31), and 42% (n=36), 39% (n=49), 47% (n=47), and 80% (n=5; discontinued because of excessive bleeding and excess mortality) in the respective streptokinase-plus-abciximab groups. In the tPA-plus-abciximab groups, the incidence of TIMI 3 flow at 90 minutes was 53% (20-mg bolus; n=36), 38% (35-mg bolus; n=40), 62% (15-mg bolus, 20-mg infusion over 30 minutes; n=50), 54% (50-mg bolus; n=28), 61% (15-mg bolus, 35-mg infusion over 30 . . . [Full Text of this Article]

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