Myocardial infarction: Summary of the timi trials

Myocardial Infarction: Summary of the TIMI Trials Remembering which "TIMI" trial is which has always been a problem for me, and I suspect it has been for others as well. Even the acronym 'TIMI" has multiple meanings, namely, Thrombolysis In Myocardial Infarction, Thrombolysis in Myocardial Ischemia, and Thrombin Inhibition in Myocardial Ischemia. I thought a review of these trials might be of interest to readers of Clinical Cardiology. What follows will summarize these trials in a repetitive format-that is, TIMI Trial Number, DrugProcedure, Major Endpoint(s), and Results. I have also included the references for those trials that have been published or presented for those who wish to know study details. Major Endpoints: Ventricular function, mortality. Results: No difference in clinical outcome at 6 weeks or one year. Global left ventricular ejection fraction averaged 50.5%. TIMI 3A4 Drug/Procedure: Heparin vs. heparin plus accelerated IV Major Endpoints: Coronary angiographic stenoses at 48 h Results: IV rtPA augmented lysis of thrombi and relief of rtPA for unstable angina and non-Q-wave MI. and TIMI grade flow. coronary narrowings better than heparin alone. TIMl 3B5> Drugs/Prncedure: rtPA vs. placebo as initial therapy in unstable anginahon-Q-wave MI and early revascularization vs. early conservative therapy (1,473 patients). Major Endpoints: Death, MI, failure of initial therapy. Results: No difference (54.2 vs. 55.5%) at 6 weeks. No difference at 1 year. TIMI 1' Drug/Procedure: Intravenous (IV) streptokinase vs. IV recombinant tissue plasminogen activator (@A) in patients with acute myocardial infarction (AMI).