Primary versus tenecteplase-facilitated percutaneous coronary intervention in patients with ST-segment elevation acute myocardial infarction (ASSENT-4 PCI): randomised trial
The LancetPublished 1 February 2006
Citations653
SJR quartileQ1
SJR score12.11
SNIP22.72
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
A strategy of full-dose tenecteplase with antithrombotic co-therapy, as used in this study and preceding PCI by 1-3 h, was associated with more major adverse events than PCI alone in STEMI and cannot be recommended.
Abstract
A strategy of full-dose tenecteplase with antithrombotic co-therapy, as used in this study and preceding PCI by 1-3 h, was associated with more major adverse events than PCI alone in STEMI and cannot be recommended.
Keywords
Medicine
The LancetPrimary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials
4,354 Citations2003Ellen C. Keeley, Judith Boura +1 more
The results seen with primary PTCA remained better than those seen with thrombolytic therapy during long-term follow-up, and were independent of both the type of throm bolytic agent used and whether or not the patient was transferred for primary P TCA.
European Heart JournalManagement of acute myocardial infarction in patients presenting with ST-segment elevation
1,447 Citations2003Frans Van de Werf
The initial diagnosis of acute myocar-dial infarction is made because the pain is associ-ated with sympathetic activation which causesvasoconstriction and increases the workload of theheart.
The LancetSingle-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial
873 Citations1999Frans Van de Werf
Tenecteplase and alteplase were equivalent for 30-day mortality and the ease of administration of tenecteplase may facilitate more rapid treatment in and out of hospital.
European Heart JournalLong distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction Final results of the randomized national multicentre trial—PRAGUE-2
808 Citations2003Petr Widimský
Long distance transport from a community hospital to a tertiary PCI centre in the acute phase of AMI is safe and markedly decreases mortality in patients presenting >3 h after symptom onset, for patients presenting within <3 h of symptoms.
The LancetEfficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: the ASSENT-3 randomised trial in acute myocardial infarction
763 Citations2001
The tenecteplase plus enoxaparin or abciximab regimens studied here reduce the frequency of ischaemic complications of an acute myocardial infarction and seems to be an attractive alternative reperfusion regimen that warrants further study.
CirculationImpact of Time to Treatment on Mortality After Prehospital Fibrinolysis or Primary Angioplasty
550 Citations2003Philippe Gabríel Steg, Éric Bonnefoy +6 more
Prehospital thrombolysis may be preferable to primary PCI for patients treated within the first 2 hours after symptom onset, and time from symptom onset should be considered when one selects reperfusion therapy in STEMI.
European Heart JournalMulticentre randomized trial comparing transport to primary angioplasty vs immediate thrombolysis vs combined strategy for patients with acute myocardial infarction presenting to a community hospital without a catheterization laboratory. The PRAGUE Study
523 Citations2000Petr Widimský
Transferring patients from community hospitals to a tertiary angioplasty centre in the acute phase of myocardial infarction is feasible and safe and is associated with a significant reduction in the incidence of reinfarction and the combined clinical end-point of death/reinfarction/stroke at 30 days when compared to standard thrombolytic therapy at the community hospital.
CirculationTimes to Treatment in Transfer Patients Undergoing Primary Percutaneous Coronary Intervention in the United States
494 Citations2005Brahmajee K. Nallamothu, Eric Bates +4 more
Total door-to-balloon times for transfer patients undergoing primary PCI in the United States rarely achieve guideline-recommended benchmarks, and current decision making should take these times into account.
CirculationNormal Flow (TIMI-3) Before Mechanical Reperfusion Therapy Is an Independent Determinant of Survival in Acute Myocardial Infarction
479 Citations2001Gregg W. Stone, David A. Cox +8 more
Patients undergoing primary PTCA in whom TIMI-3 flow is present before angioplasty present with greater clinical and angiographic evidence of myocardial salvage, are less likely to develop complications related to left ventricular failure, and have improved early and late survival.
JAMAPharmacological Facilitation of Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction
430 Citations2005Bernard J. Gersh, Gregg W. Stone +2 more
In patients presenting 2 to 3 hours after onset of symptoms, a strategy of facilitated PCI may move patients from the plateau to the descending limb of the curve, with a substantial improvement in myocardial salvage and mortality.
CirculationEfficacy and Safety of Tenecteplase in Combination With the Low-Molecular-Weight Heparin Enoxaparin or Unfractionated Heparin in the Prehospital Setting
387 Citations2003Lars Wallentin, Patrick Goldstein +10 more
Tenecteplase and UFH are recommended as the routine pharmacological reperfusion treatment in the prehospital setting and reduces early ischemic events, but lower doses of ENOX need to be tested in elderly patients.
Journal of the American College of CardiologyA randomized trial comparing primary angioplasty with a strategy of short-acting thrombolysis and immediate planned rescue angioplasty in acute myocardial infarction: the PACT trial
384 Citations1999Allan M. Ross, Karin S. Coyne +11 more
Tailored thrombolytic regimens compatible with subsequent interventions lead to more frequent early recanalization (before cath arrival), which facilitates greater LV function preservation with no augmentation of adverse events.
HeartProspective randomised comparison between thrombolysis, rescue PTCA, and primary PTCA in patients with extensive myocardial infarction admitted to a hospital without PTCA facilities: a safety and feasibility study
273 Citations1999Frank Vermeer, Anton J.M. Oude Ophuis +7 more
Assessment of the safety and feasibility of acute transport followed by rescue percutaneous transluminal coronary angioplasty (PTCA) or primary PTCA in patients with acute myocardial infarction found it feasible and safe.
Journal of the American College of CardiologyCombined Angioplasty and Pharmacological Intervention Versus Thrombolysis Alone in Acute Myocardial Infarction (CAPITAL AMI Study)
253 Citations2005Michel R. Le May, George A. Wells +13 more
In patients presenting with high-risk STEMI, TNK plus immediate angioplasty reduced the risk of recurrent ischemic events compared with TNK alone and was not associated with an increase in major bleeding complications.
CirculationTrial of Abciximab With and Without Low-Dose Reteplase for Acute Myocardial Infarction
204 Citations2000E. Magnus Ohman, H Gold +47 more
CirculationImpact of Prehospital Thrombolysis for Acute Myocardial Infarction on 1-Year Outcome
203 Citations2004Nicolas Danchin, Didier Blanchard +10 more
The 1-year outcome of patients treated with PHT compares favorably with that of patientstreated with other modes of reperfusion therapy; this favorable trend persists after multivariate adjustment.
European Heart Journal?Facilitation of primary coronary angioplasty by early start of a glycoprotein 2b/3a inhibitor: results of the ongoing tirofiban in myocardial infarction evaluation (On-TIME) trial
174 Citations2004A. Hof
JAMAEarly Administration of Reteplase Plus Abciximab vs Abciximab Alone in Patients With Acute Myocardial Infarction Referred for Percutaneous Coronary Intervention<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>
166 Citations2004Adnan Kastrati
Early administration of reteplase plus abcximab does not lead to a reduction of infarct size compared with abciximab alone in patients with acute MI referred for PCI.
CirculationA prospective, placebo-controlled, randomized trial of intravenous streptokinase and angioplasty versus lone angioplasty therapy of acute myocardial infarction.
165 Citations1992William W. O’Neill, Richard Weintraub +8 more
Adjunctive intravenous streptokinase therapy does not enhance early preservation of ventricular function, improve arterial patency rates, or lower restenosis rates after PTCA therapy of acute MI, and should not be routinely performed.
CirculationAdjunctive Platelet Glycoprotein IIb/IIIa Receptor Inhibition With Tirofiban Before Primary Angioplasty Improves Angiographic Outcomes
165 Citations2003David P. Lee, Niall Herity +8 more
The TIGER-PA pilot trial suggests that early administration of tirofiban improves angiographic outcomes and is safe and feasible in patients undergoing primary angioplasty for acute myocardial infarction.
American Heart JournalFacilitated percutaneous coronary intervention versus primary percutaneous coronary intervention: design and rationale of the facilitated intervention with enhanced reperfusion speed to stop events (FINESSE) trial
111 Citations2004Stephen G. Ellis, Paul W. Armstrong +7 more
The FINESSE study will answer important questions regarding the efficacy and safety of "upstream" medical therapy followed by planned intervention for patients with ST-elevation MI, potentially expanding the population eligible for a primary PCI approach.
Journal of the American College of CardiologyActivation of prothrombin accompanying thrombolysis with recombinant tissue-type plasminogen activator
109 Citations1992Paul R. Eisenberg, Burton E. Sobel +1 more
Results indicate that thrombin activity increases in patients given rt-PA at least in part because of activation of the coagulation system leading to activation of prothrombin, which may be of value as conjunctive treatment to potentiate the efficacy of pharmacologic thrombolysis.
European Heart JournalEarly eptifibatide improves TIMI 3 patency before primary percutaneous coronary intervention for acute ST elevation myocardial infarction: results of the randomized integrilin in acute myocardial infarction (INTAMI) pilot trial
94 Citations2005Uwe Zeymer, Ralf Zahn +8 more
In this pilot trial, double bolus eptifibatide given in the emergency room improved TIMI 3 grade flow of the infarct-related coronary artery before PCI and whether this advantage translates into an improvement in clinical outcome should be tested in a trial with primary clinical endpoints.
The American Journal of CardiologyEffects of abciximab pretreatment in patients with acute myocardial infarction undergoing primary angioplasty
88 Citations2002Simona Zorman, Darko Zorman +1 more
It is indicated that abciximab pretreatment in patients with ST-elevation myocardial infarction may be beneficial because it partially restores epicardial patency before a primary angioplasty attempt and facilitates early ST-segment elevation resolution.
European Heart JournalPre-hospital reperfusion therapy: a strategy to improve therapeutic outcome in patients with ST-elevation myocardial infarction
81 Citations2005Kurt Huber, Raffaele De Caterina +5 more
Thrombolytic therapy is still the fastest and best accessible reperfusion treatment for most patients presenting with acute STEMI, as indicated in the international guidelines, and PPCI is only available on an average for 15–20% of patients suffering from STEMI in the western world.
The American Journal of CardiologyEffect of tirofiban before primary angioplasty on initial coronary flow and early ST-segment resolution in patients with acute myocardial infarction
78 Citations2003Donald E. Cutlip, Mark J. Ricciardi +6 more
Patients receiving early tirofiban treatment were more likely to achieve complete (>70%) ST-segment resolution at 90 minutes and be able to undergo coronary angiography for further evaluation.
The American Journal of CardiologyComparison of reperfusion regimens with or without tirofiban in ST-elevation acute myocardial infarction
35 Citations2004Marco Antonio Martínez‐Ríos, Martı́n Rosas +10 more
The hypothesis that platelet glycoprotein IIb/IIIa inhibitors play a key role not only in the atherothrombosis process, but also in the disturbances of microcirculation and tissue perfusion is supported.
