OBJECTIVES: We compared a strategy of tenecteplase (TNK)-facilitated angioplasty with one of TNK alone in @entity1 presenting with high-risk @entity583 ( @entity583 ). BACKGROUND: Previous trials show that thrombolysis followed by immediate angioplasty for the treatment of @entity583 does not improve @entity63 outcomes compared with thrombolysis alone and is associated with excessive @entity548 complications. Since the publication of these trials, however, significant pharmacological and technological advances have occurred. METHODS: We randomized 170 @entity1 with high-risk @entity583 to treatment with TNK alone (84 @entity1 ) or TNK-facilitated angioplasty (86 @entity1 ). The primary end point was a composite of @entity204 , reinfarction, recurrent unstable @entity63 , or @entity64 at six months. RESULTS: At six months, the incidence of the primary end point was 24.4% in the TNK-alone group versus 11.6% in the TNK-facilitated angioplasty group (p = 0.04). This difference was driven by a reduction in the rate of recurrent unstable @entity63 (20.7% vs. 8.1%, p = 0.03). There was a trend toward a lower reinfarction rate with TNK-facilitated angioplasty (14.6% vs. 5.8%, p = 0.07). No significant differences were observed in the rates of @entity204 or @entity64 . Major @entity548 was observed in 7.1% of the TNK-alone group and in 8.1% of the TNK-facilitated angioplasty group (p = 1.00). CONCLUSIONS: In @entity1 presenting with high-risk @entity583 , TNK plus immediate angioplasty reduced the risk of recurrent @entity63 events compared with TNK alone and was not associated with an increase in major @entity548 complications.

Combined angioplasty and pharmacological intervention versus thrombolysis alone in acute XXXX (CAPITAL AMI study).

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia', 'ischemic'] @entity583 :: ('MESH:D009203', 'Disease') :: ['STEMI', 'ST-segment elevation myocardial infarction'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity583 :: (MESH:D009203,Disease) :: ['myocardial infarction']
