Author + information
- Eric J. Topol, MD, FACC*,1,
- Robert M. Califf, MD†,
- Dean J. Kereiakes, MD, FACC‡ and
- Barry S. George, MD§
- ↵1Address for reprints: Eric J. Topol, MD, Division of Cardiology, University of Michigan Medical Center, UH B1 F245, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109-0022.
The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trial was a randomized, multicenter study performed to determine whether immediate or elective (7 day) coronary angioplasty was preferable once infarct vessel recanalization had been confirmed. In addition, a major focus of the effort was to collect detailed information about the clinical course and outcome of all 386 patients entered into the trial, whether randomized or not.
This article reports the major end points of acute and follow-up mortality, the incidence and timing of recurrent ischemic events and acute and convalescent infarct-vessel patency. The optimal timing of coronary angioplasty and intravenous tissue plasminogen activator (rt-PA) administration is discussed. The subsets of patients who: 1) were unsuccessfully treated with rt-PA; 2) had a minimal residual (<50%) lesion after rt-PA; or 3) underwent emergency coronary bypass surgery are presented. A current practical approach to acute intervention is extrapolated from the TAMI results.
- American College of Cardiology Foundation