acute myocardial infarction - myocardial revascularization - >6h from onset of symptoms clinical trials results meta-analysis

<h1> <a href="TM1-1-myocardial revascularization-acute myocardial infarction" > <strong>acute myocardial infarction</strong> - myocardial revascularization </a> - >6h from onset of symptoms trial results systematic overview and meta-analysis </h1> <h2>Main characteristics of the included studies</h2> <table> <tr> <th>Trial</th> <th>Treatments</th> <th>Patients</th> <th>Methods</th> </tr> <tr> <td> <a href="../TRC_t6752.htm"> TOMIIS, 1994 </a> <br> </td> <td> late PTCA<br>  <i>versus</i> <br> no PTCA </td> <td> patients with a recent, first Q-wave myocardial infarction and an occluded infarct-related coronary artery </td> <td> follow-up 4 months, fixed<br> n=25/19<br> <br> open <br> </td> </tr> <tr> <td> <a href="../TRC_t6753.htm"> Horie et al, 1998 </a> <br> </td> <td> late revascularization by primary PTCA<br>  <i>versus</i> <br> no PTCA </td> <td> patients with initial Q-wave anterior myocardial infarction >24 hours after onset </td> <td> follow-up 50 months, mean<br> n=44/39<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t6754.htm"> TOAT, 2002 </a> <br> </td> <td> late revascularization (late intervention and stent to the LAD + medical therapy)<br>  <i>versus</i> <br> conservative therapy (medical therapy) </td> <td> symptom-free patients after acute myocardial infarction </td> <td> follow-up 12 months, fixed<br> n=32/34<br> <br> open <br> </td> </tr> <tr> <td> <a href="../TRC_t6755.htm"> DECOPI, 2004 </a> <br> </td> <td> percutaneous revascularization carried out 2-15 days after symptom onset<br>  <i>versus</i> <br> medical treatment </td> <td> patients with a first Q-wave myocardial infarction and an occluded infarct vessel </td> <td> follow-up 34 months, mean<br> n=109/103<br> <br> open <br> </td> </tr> <tr> <td> <a href="../TRC_t6756.htm"> Silva et al, 2005 </a> <br> </td> <td> percutaneous coronary intervention<br>  <i>versus</i> <br> conservative therapy (no-PCI) </td> <td> patients with occluded infarct-related artery between 12 h and 14 days post-anterior MI were </td> <td> follow-up 6 months, fixed<br> n=18/18<br> <br> open <br> </td> </tr> <tr> <td> <a href="../TRC_t6757.htm"> OAT, 2006 </a> <br> </td> <td> routine PCI and stenting<br>  <i>versus</i> <br> optimal medical therapy alone </td> <td> stable patients who had total occlusion of the infarct-related artery 3 to 28 days after myocardial infarction and who met a high-risk criterion ( </td> <td> follow-up 35 months, mean<br> n=1082/1084<br> <br> open <br> </td> </tr> <tr> <td> <a href="../TRC_t6758.htm"> TOSCA-2, 2006 </a> <br> NCT00025766 </td> <td> PCI with stenting<br>  <i>versus</i> <br> optimal medical therapy alone </td> <td> patients with an occluded native infarct-related artery 3 to 28 days after MI </td> <td> follow-up 12 months, fixed<br> n=195/186<br> <br> open <br> </td> </tr> <tr> <td> <a href="../TRC_t8091.htm"> LATE, 1993 </a> <br> </td> <td> intravenous alteplase (100 mg over 3 h)<br>  <i>versus</i> <br> placebo </td> <td> patients with symptoms and electrocardiographic criteria consistent with AMI between 6 and 24 h from symptom onset </td> <td> follow-up 6 mo<br> n=2836/2875<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t8278.htm"> EMERAS (7-12h), 1993 </a> <br> </td> <td> intravenous streptokinase 1.5 MU<br>  <i>versus</i> <br> placebo </td> <td> patients presenting 7-12 h from symptom onset </td> <td> follow-up <br> n=2257/2277<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t9036.htm"> TAMI 6, 1992 </a> <br> </td> <td> tissue-type plasminogen activator 100 mg over 2 hours<br>  <i>versus</i> <br> placebo </td> <td> patients with 6 to 24 hours of symptoms and ECG ST elevation </td> <td> follow-up 6 months<br> n=96/101<br> Parallel groups<br> double blind <br> USA </td> </tr> </table> <h2>References</h2> <p> <b>TOMIIS, 1994 : </b> Dzavik V, Beanlands DS, Davies RF, Leddy D, Marquis JF, Teo KK, Ruddy TD, Burton JR, Humen DPEffects of late percutaneous transluminal coronary angioplasty of an occluded infarct-related coronary artery on left ventricular function in patients with a recent (< 6 weeks) Q-wave acute myocardial infarction (Total Occlusion Post-Myocardial Infarction Intervention Study [TOMIIS]--a pilot study). <i>Am J Cardiol 1994;73:856-61</i> [PMID 8184807] </p> <p> <b>Horie et al, 1998 : </b> Horie H, Takahashi M, Minai K, Izumi M, Takaoka A, Nozawa M, Yokohama H, Fujita T, Sakamoto T, Kito O, Okamura H, Kinoshita MLong-term beneficial effect of late reperfusion for acute anterior myocardial infarction with percutaneous transluminal coronary angioplasty. <i>Circulation 1998;98:2377-82</i> [PMID 9832481] </p> <p> <b>TOAT, 2002 : </b> Yousef ZR, Redwood SR, Bucknall CA, Sulke AN, Marber MSLate intervention after anterior myocardial infarction: effects on left ventricular size, function, quality of life, and exercise tolerance: results of the Open Artery Trial (TOAT Study). <i>J Am Coll Cardiol 2002;40:869-76</i> [PMID 12225709] </p> <p> <b>DECOPI, 2004 : </b> Steg PG, Thuaire C, Himbert D, Carrié D, Champagne S, Coisne D, Khalifé K, Cazaux P, Logeart D, Slama M, Spaulding C, Cohen A, Tirouvanziam A, Montély JM, Rodriguez RM, Garbarz E, Wijns W, Durand-Zaleski I, Porcher R, Brucker L, Chevret S, Chastang CDECOPI (DEsobstruction COronaire en Post-Infarctus): a randomized multi-centre trial of occluded artery angioplasty after acute myocardial infarction. <i>Eur Heart J 2004;25:2187-94</i> [PMID 15589635] </p> <p> <b>Silva et al, 2005 : </b> Silva JC, Rochitte CE, Júnior JS, Tsutsui J, Andrade J, Martinez EE, Moffa PJ, Menegheti JC, Kalil-Filho R, Ramires JF, Nicolau JCLate coronary artery recanalization effects on left ventricular remodelling and contractility by magnetic resonance imaging. <i>Eur Heart J 2005;26:36-43</i> [PMID 15615797] </p> <p> <b>OAT, 2006 : </b> Hochman JS, Lamas GA, Buller CE, Dzavik V, Reynolds HR, Abramsky SJ, Forman S, Ruzyllo W, Maggioni AP, White H, Sadowski Z, Carvalho AC, Rankin JM, Renkin JP, Steg PG, Mascette AM, Sopko G, Pfisterer ME, Leor J, Fridrich V, Mark DB, Knatterud GLCoronary intervention for persistent occlusion after myocardial infarction. <i>N Engl J Med 2006;355:2395-407</i> [PMID 17105759] </p> <p> <b>OAT, 2006 : </b> Malek LA, Reynolds HR, Forman SA, Vozzi C, Mancini GB, French JK, Dziarmaga M, Renkin JP, Kochman J, Lamas GA, Hochman JSLate coronary intervention for totally occluded left anterior descending coronary arteries in stable patients after myocardial infarction: Results from the Occluded Artery Trial (OAT). <i>Am Heart J 2009;157:724-32</i> [PMID 19332202] </p> <p> <b>TOSCA-2, 2006 : </b> Dzavík V, Buller CE, Lamas GA, Rankin JM, Mancini GB, Cantor WJ, Carere RJ, Ross JR, Atchison D, Forman S, Thomas B, Buszman P, Vozzi C, Glanz A, Cohen EA, Meciar P, Devlin G, Mascette A, Sopko G, Knatterud GL, Hochman JSRandomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function: the Total Occlusion Study of Canada (TOSCA)-2 trial. <i>Circulation 2006;114:2449-57</i> [PMID 17105848] </p> <p> <b>LATE, 1993 : </b> Late Assessment of Thrombolytic Efficacy (LATE) study with alteplase 6-24 hours after onset of acute myocardial infarction. <i>Lancet 1993 Sep 25;342:759-66</i> [PMID 8103874] </p> <p> <b>EMERAS (7-12h), 1993 : </b> Randomised trial of late thrombolysis in patients with suspected acute myocardial infarction. EMERAS (Estudio Multicéntrico Estreptoquinasa Repúblicas de América del Sur) Collaborative Group. <i>Lancet 1993 Sep 25;342:767-72</i> [PMID 8103875] </p> <p> <b>TAMI 6, 1992 : </b> Topol EJ, Califf RM, Vandormael M, Grines CL, George BS, Sanz ML, Wall T, O'Brien M, Schwaiger M, Aguirre FVA randomized trial of late reperfusion therapy for acute myocardial infarction. Thrombolysis and Angioplasty in Myocardial Infarction-6 Study Group. <i>Circulation 1992 Jun;85:2090-9</i> [PMID 1591828] </p>