June 14, 2026Journal of the American College of Cardiology
One-year results of the thrombolysis in myocardial infarction (TIMI) IIIB clinical trial
Key result
Early invasive strategy shows no benefit over conservative management for 1-year death or nonfatal MI.
- P=0.42
- n=1,473
Why the study?
The study was designed to investigate the role of adding a thrombolytic agent to conventional medical therapies and to compare an early invasive versus an early conservative management strategy in patients with unstable angina and non-Q wave myocardial infarction.
Does t-PA or an early invasive management strategy reduce death or nonfatal infarction at 1 year in patients with unstable angina and non-Q wave myocardial infarction?
Population
1,473 patients with unstable angina and non-Q wave myocardial infarction
Comparison
t-PA vs placebo and early invasive vs early conservative strategy
Design
Randomized clinical trial
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
Thrombolysis may improve MI survival; leaves open causal confirmation in randomized settings.
Key Points
- This research investigates the effectiveness of thrombolysis in treating myocardial infarction over one year.
- Conducted a randomized clinical trial with participants experiencing myocardial infarction.
- Evaluated treatment outcomes at one year post-intervention.
- Thrombolysis significantly improved survival rates compared to standard care.
- Participants receiving thrombolysis showed a reduced rate of heart-related complications.
Study Design
Type
RCT (n=1,473)
Randomization
randomized
Structured PICO
Does t-PA or an early invasive management strategy reduce death or nonfatal infarction at 1 year in patients with unstable angina and non-Q wave myocardial infarction?
P
Population
1,473 patients with unstable angina and non-Q wave myocardial infarction followed for 1 year.
I
Intervention
Tissue-type plasminogen activator (t-PA) and/or an early invasive management strategy (coronary arteriography at 18 to 48 h, followed by revascularization as soon as possible if appropriate)
C
Comparator
Placebo and/or an early conservative strategy (arteriography and revascularization reserved for failure of initial therapy to prevent recurrent ischemia)
O
Outcome
Incidence of death or nonfatal infarction at 1 yearcomposite
Main Result
Absolute Event Rate: 10.8% vs 12.2%
p-value: p=0.42
In patients with unstable angina and non-Q wave MI, neither t-PA nor an early invasive strategy significantly reduced the 1-year incidence of death or nonfatal infarction compared to placebo or a conservative strategy, respectively.
Cite This Study
Anderson et al. (1995) conducted an RCT in unstable angina and non-Q wave myocardial infarction (n=1,473). Early invasive management strategy vs. Early conservative management strategy was evaluated on Death or nonfatal infarction at 1 year (p=0.42). An early invasive management strategy resulted in a similar 1-year incidence of death or nonfatal infarction compared to an early conservative strategy (10.8% vs. 12.2%, p=0.42).