ABSTRACT
<p><b>OBJECTIVE</b>In this randomized, open-label, multicenter, angiographic trial, we compared the efficacy and safety of tenecteplase (TNK-tPA) with alteplase (rt-PA) in Chinese patients with acute myocardial infarction.</p><p><b>METHOD</b>Patients with acute ST-elevation myocardial infarction and pain to hospital time within 6 hours from October 2002, to March 2004 were randomly assigned a body weight-adjusted bolus of TNK-tPA (0.53 mg/kg over more than 10 s, n = 58) or front loaded rt-PA (< or = 100 mg, n = 52). Coronary angiography was performed at 90 min after initiating study drugs. All patients received aspirin and heparin (target activated partial thromboplastin time: 50-70 s). The primary end point of the trial was the rate of TIMI grade 3 flow at 90 minutes. Other end points included the rate of TIMI grade 2/3 flow at 90 minutes, all cause mortality at 30 days, the moderate/severe hemorrhage without intracranial hemorrhage (ICH) and ICH within 30 days.</p><p><b>RESULTS</b>TIMI grade 3 flow at 90 minutes (68.4% vs. 66.7%, P = 1.00), TIMI grade 2 or 3 at 90 minutes (89.5% vs. 80.4%, P = 0.278), total mortality at 30 days (13.8% vs. 9.6%, P = 0.565), the rate of moderate/severe hemorrhage (8.6% vs. 5.8%, P = 0.72) and incidence of ICH (3.5% vs. 1.9%, P = 1.00) were all similar in TNK-tPA treated patients compared to rt-PA treated patients.</p><p><b>CONCLUSION</b>The efficacy of single-bolus, weight-adjusted TNK-tPA fibrinolytic regimen is equivalent to front-loaded alteplase in terms of the rates of TIMI grade 3 flow, TIMI 2 or 3 flow. Incidences of moderate/severe hemorrhage, ICH and 30-days mortality were similar in TNK-tPA and rt-PA treated patients.</p>
Subject(s)
Aged , Humans , Middle Aged , Myocardial Infarction , Drug Therapy , Thrombolytic Therapy , Tissue Plasminogen Activator , Therapeutic Uses , Treatment OutcomeABSTRACT
Objective To observe the serum B-type natriuretic peptide(BNP)changes in patients with acute coronary syndrome during percutaneous coronary intervention(PCI).Method The serum BNP level was determined and the heart function was assessed in 236 consecutive patients with acute coronary syndrome(ACS) admitted to CCU and in 54 normal normal suvjects as control from January 2005 to December 2006 in Tongji Hospital.The ACS patients were further divided into various subgroups according to the involved arteries and performance of PCI.Serum BNP,hypersensitive c respose protein(HsCRP)level,amd heart comstitution and function were analyzed.Results The serum BNP and HsCRP level were significantly increased in patients with ACS [(332.06?483.17)ng/L and(31.06?52.15)mg/L]more than those in normal subjects [(81.44?195.55)ng/L and(11.15?20.78)mg/L,respectively,P
ABSTRACT
Objective To observe the efficacy and safety of applying sirolimus-eluting stents in emergency percutaneous coronary intervention (PCI) for the patients with acute myocardial infarction (AMI).Methods In total,220 patients with AMI were enrolled in this study at Shanghai Tongji Hospital, divided into two groups,one with bare-metal stent and the other with sirolimus-eluting stent.Cardiovascular fatality,major adverse cardiac events (MACE) and target vessel revascularization (TVR) were observed one and six months after PCI in the two groups.Results There was no significant difference in overall fatality and MACE in the 1~(st) or 6~(th) months after PCI between the two groups.Three cardiogenic deaths occurred in bare-metal stent group with a fatality of 2.8 percent,and five deaths in sirolimus-eluting stent group with a fatality of 4.5 percent in six months after PCI.However,rate of restenosis in those with sirolimus-eluting stents was significantly lower than that of bare-metal stents (6.0 percent vs 16.1 percent,P