Invasive versus conservative strategies in unstable angina and non-Q-wave myocardial infarction following treatment with Tirofiban: Rationale and study design of the international TACTICS-TIMI 18 trial

American Journal of Cardiology

Volumn 82, Issue 6 A, 1998, Pages 731-736

  Cannon, Christopher P ^a   Weintraub, William S ^b   Demopoulos, Laura A ^b   Robertson, Deborah H ^b   Gormley, Glenn J ^b   Braunwald, Eugene ^b  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; EPTIFIBATIDE; FIBRINOGEN RECEPTOR ANTAGONIST; GLYCOPROTEIN IIB; GLYCOPROTEIN IIIA; HYPOCHOLESTEROLEMIC AGENT; LAMIFIBAN; NITRATE; TIROFIBAN; TROPONIN I; TROPONIN T; UNCLASSIFIED DRUG;

ACUTE HEART INFARCTION; ARTICLE; BLOOD CLOT LYSIS; CLINICAL PROTOCOL; CLINICAL TRIAL; CONSERVATIVE TREATMENT; CONTROLLED STUDY; DEATH; FEMALE; HEART CATHETERIZATION; HEART MUSCLE REVASCULARIZATION; HEART SURGERY; HOSPITALIZATION; HUMAN; INTERMETHOD COMPARISON; INTRAVENOUS DRUG ADMINISTRATION; MAJOR CLINICAL STUDY; MALE; MULTICENTER STUDY; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; TREATMENT OUTCOME; UNSTABLE ANGINA PECTORIS;

ADOLESCENT; ANGINA, UNSTABLE; ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY; CORONARY ANGIOGRAPHY; CORONARY ARTERY BYPASS; ELECTROCARDIOGRAPHY; FEMALE; FOLLOW-UP STUDIES; HUMANS; MALE; MYOCARDIAL INFARCTION; PLATELET AGGREGATION INHIBITORS; PLATELET GLYCOPROTEIN GPIIB-IIIA COMPLEX; RECURRENCE; RESEARCH DESIGN; TREATMENT OUTCOME; TYROSINE;

EID: 0032530442     PISSN: 00029149     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0002-9149(98)00540-2     Document Type: Article

References (30)

1. Braunwald E, Mark DB, Jones RH, Cheitlin MD, Fuster V, McCauley KM, Edwards C, Green LA, Mushlin AI, Swain JA, et al. Unstable Angina: Diagnosis and Management. Clinical Practice Guideline Number 10. Rockville, MD: Agency for Health Care Policy and Research and the National Heart, Lung, and Blood Institute, Public Health Service, U.S. Department of Health and Human Services, 1994:154.
2. Cannon CP. Optimizing the treatment of unstable angina. J Thromb Thrombolysis 1995;2:205-218.
3. Lewis HD, Davis JW, Archibald DG, Steinke WE, Smitherman TC, Doherty JE, Schnaper HW, LeWinter MM, Linares E, Pouget JM, Sabharwal SC, Chesler E, DeMots H. Protective effects of aspirin against acute myocardial infarction and death in men with unstable angina. N Engl J Med 1983;309:396-403.
4. Cairns JA, Gent M, Singer J, Finnic KJ, Froggatt GM, Holder DA, Jablonsky G, Kostuk WJ, Melendez LJ, Myers MG, Sackett DL, Sealey BJ, Tanser PH. Aspirin, sulfinpyrazone, or both in unstable angina. N Engl J Med 1985;313: 1369-1375.
5. Theroux P, Ouimet H, McCans J, Latour J-G, Joly G, Levy G, Pelletier E, Juneau M, Stasiak J, deGuise P, Pelletier GB, Rinzler D, Waters DD. Aspirin, heparin or both to treat unstable angina. N Engl J Med 1988;319:1105-1111.
6. The RISC Group. Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. Lancet 1990;336:827-830.
7. Theroux P, Waters D, Qiu S, McCans J, de Guise P, Juneau M. Aspirin versus heparin to prevent myocardial infarction during the acute phase of unstable angina. Circulation 1993;88:2045-2048.
8. Cohen M, Adams PC, Parry G, Xiong J, Chamberlain D, Wieczorek I, Fox KAA, Chesebro JH, Strain J, Keller C, et al, and the Antithrombotic Therapy in Acute Coronary Syndromes Research Group. Combination antithrombotic therapy in unstable rest angina and non-Q-wave infarction in nonprior aspirin users. Primary end points analysis from the ATACS trial. Circulation 1994;89:81-88.
9. Oler A, Whooley MA, Oler J, Grady D. Adding heparin to asprin reduces the incidence of myocardial infarction and death in patients with unstable angina. A meta-analysis. JAMA 1996;276:811-815.
10. The Platelet Receptor Inhibition for Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) Trial Investigators. Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non-q-wave myocardial infarction. N Engl J Med 1998;338: 1488-1497.
11. The Platelet Receptor Inhibition For Ischemic Syndrome Management (PRISM) Study Investigators. A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. N Engl J Med 1998;338:1498-1505.
12. The Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) Trial Investigators. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patient with acute coronary syndromes without persistent ST-segment elevation: a randomized, placebo-controlled clinical trial. N Engl J Med (in press).
13. Serruys PW, de Jaegere P, Kiemeneij F, Macaya C, Rutsch W, Heyndrickx G, Emanuelsson H, Marco J, Legrand V, Materne P, et al, for the BENESTENT Study Group. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med 1994; 331:489-495.
14. Fischman DL, Leon MB, Baim DS, Schatz RA, Savage MP, Penn I, Detre K, Veltri L, Ricci D, Nobuyoshi M, Cleman M, et al, for the Stent Restenosis Study Investigators. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 1994;331: 496-501.
15. Schömig A, Neumann F-J, Kastrati A, Schühlen H, Blasini R, Hadamitzky M, Walter H, Zitzmann-Roth E-M, Richardt G, Alt E, Schmitt C, Ulm K. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med 1996;334:1084-1089.
16. The TIMI IIIB Investigators. Effects of tissue plasminogen activator and a comparison of early invasive and conservative strategies in unstable angina and non-Q-wave myocardial infarction: results of the TIMI IIIB Trial. Circulation 1994;89:1545-1556.
17. Anderson HV, Cannon CP, Stone PH, Williams DO, McCabe CH, Knatterud GL, Thompson B, Willerson JT, Braunwald E, for the TIMI-IIIB Investigators. One-year results of the Thrombolysis in Myocardial Infarction (TIMI) IIIB clinical trial. A randomized comparison of tissue-type plasminogen activator versus placebo and early invasive versus early conservative strategies in unstable angina and non-Q-wave myocardial infarction. J Am Coll Cardiol 1995;26:1643-1650.
18. Boden WE, O'Rourke RA, Crawford MH, Blaustein AS, Deedwania PC, Zoble RG, Wexler LF, Pepine CJ, Ferry DR, Chow BK, Lavori PW, for the Veterans Affairs Non-Q-Wave Infaction Strategies in Hospital (VANQWISH) Trial Investigators. Outcomes in patients with acute non-Q-wave myocardial infarction randomly assigned to an invasive as compared with a conservative strategy. N Engl J Med 1998;338:1785-1792.
19. Braunwald E. Unstable angina: a classification. Circulation 1989;80:410-414.
20. Weintraub WS, Culler SD, Kosinski A, Becker ER, Mahoney E, Burnette J, Spertus JA, Feeny D, Cohen DJ, Krumholtz H, et al. Economics, health related quality of life and cost effectiveness methods for the TACTICS (Treat Angina with Aggrastat and Determine Cost of Therapy with an invasive or conservative strategy) - TIMI 18 Trial. Am J Cardiol (in press).
21. International Joint Efficacy Comparison of Thrombolytics. Randomised, double-blind comparison of reteplase double-bolus administration with streptokinase in acute myocardial infarction (INJECT): trial to investigate equivalence. Lancet 1995;346:329-336.
22. The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO III) Investigators. A comparison of reteplase with alteplase for acute myocardial infarction. N Engl J Med 1997;337:1118-1123.
23. Antiplatelet Trialist Collaboration. Collaborative overview of randomised trials of antiplatelet therapy - I: prevention of death myocardial infarction and stroke by prolongued antiplatelet therapy in various categories of patients. BMJ 1994;308:81-106.
24. The EPIC Investigators. Use of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptor in high risk angioplasty. N Engl J Med 1994;330:956-961.
25. The EPILOG Investigators. Platelet glycoprotein IIb/IIIa receptor blockade and low-dose heparin during percutaneous coronary revascularization. N Engl J Med 1997;336:1689-1696.
26. The RESTORE Investigators. The effects of platelet glycoprotein IIb/IIIa blockade with tirofiban on adverse cardiac events in patients with unstable angina or acute myocardial infarction undergoing coronary angioplasty. Circulation 1997;96:1445-1453.
27. The PARAGON Investigators. International, randomized, controlled trial of lamifiban (a platelet glycoprotein IIb/IIIa inhibitor), heparin or both in unstable angina. Circulation 1998;97:2386-2395.
28. Tu JV, Sykora K, Naylor CD, for the Steering Committee of the Cardiac Care Network of Ontario. Assessing the outcomes of coronary artery bypass graft surgery: how many risk factors are enough. J Am Coll Cardiol 1997;30:1317-1323.
29. Hamm CW, Ravkilde J, Gerhardt W, Jorgensen P, Peheim E, Ljungdahl L, Goldmann B, Katus HA. The prognostic value of troponin T in unstable angina. N Engl J Med 1992;327:146-50.
30. Antman EM, Tanasijevic MJ, Thompson B, Schactman M, McCabe CH, Cannon CP, Fischer GA, Fung AY, Thompson C, Wybenga D, Braunwald E. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996;335:1342-1349.