CAPITAL-AMI研究课件（PPT 6页）.ppt

Combined Angioplasty and Pharmacological Intervention Versus Thrombolytics Alone in Acute Myocardial Infarction Among patients with STEMI, treatment with full-dose TNK with transfer for PCI was associated with a lower rate of the composite of death, reinfarction, recurrent unstable ischemia, or stroke at 30 days compared with TNK alone, without an increased risk of major bleeding. Results of the present trial differ from earlier trials such as the TIMI II trial, which showed no benefit of medical therapy plus percutaneous transluminal coronary angioplasty (PTCA) over medical therapy alone. Differing results are not unexpected, given the substantial changes in practice patterns since the earlier trials (widespread use of stents, optimal anticoagulation, and use of thienopyridines). Event rates at 6 months are pending. Presented at American College of Cardiology Scientific Sessions 2004 Presented by Dr. Michel R. Le May CAPITAL AMI Trial Endpoints (30 days and 6 months): Composite of death, reinfarction, recurrent unstable ischemia, or stroke CAPITAL AMI Trial Presented at ACC Scientific Sessions 2004 170 patients presenting with ST elevation acute MI with chest pain ≥30 minutes and within six hours of symptom onset Randomized, open-label, multicenter Thrombolytic Therapy Full-dose Tenectaplase (TNK) n=84 Thrombolytic Therapy, Transfer, and PCI Full-dose Tenectaplase (TNK) followed by transfer and subsequent percutaneous coronary intervention (PCI) n=86 In-Hospital Composite Event Rate p=0.017 Presented at ACC Scientific Sessions 2004 CAPITAL AMI Trial % The composite in-hospital event rate of death, reinfarction, recurrent unstable ischemia, or stroke was lower in the TNK+PCI arm compared with the TNK alone arm, driven by a reduction in reinfarction and recurrent unstable ischemia. TNK TNK+PCI TNK TNK+PCI In-Hospital Reinfarction p=0.046 In-Hospital Recurrent Unstable Ischemia p=0.02 Presented at ACC Scientific Sessions 2004 CAPITAL AMI Trial % PCI was performe