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【医学课件】timiiiia研究课件.ppt

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IV Heparin, (ASA), Beta-blockers, Nitrates, Ca++ blockers
Randomize
Angio 18-36 hrs
t-PA
mg/kg over 90 mins
391 IV Heparin, (ASA), Beta-blockers, Nitrates, Ca++ blockers
Randomize
Angio 18-36 hrs
t-PA
mg/kg over 90 mins
391 Patients with Unstable Angina / NQWMI
Placebo
Primary Endpoint:
Death, MI,
Positive ETT 6 weeks
Follow-up 6 weeks
Circulation 1993;87:38-52
Baseline Angio
Angio Exclusion:
no CAD or LMain
TIMI IIIA
Protocol Design
： :// ；；：
Apparent thrombus
35%
Possible thrombus
30%
No thrombus
35%
Improvement in Culprit Lesion: 25% t-PA vs. 19% placebo p=NS
TIMI IIIA Investigators. Circulation 1993;87:38-52.
TIMI IIIA
Effects of tPA on Coronary Lesions
Primary Results
BASELINE ANGIORAPHY:
ANGIORAPHY AFTER tPA:
ASA, IV Heparin, Beta-blockers, Nitrates, Ca++ blockers
Randomize
ETT 6 weeks
Early Invasive:
Cath 18-48 h
PTCA/CABG prn
1473 Patients with Unstable Angina / NQWMI
Early Conservative:
ST Holter, ETT Thallium
Cath/PTCA if +ischemia
1o Endpoint Inv-Cons:
Death, MI,
Positive ETT - 6 weeks
Follow-up 1 year
Circulation 1994;89:1545-56
2x2 Factorial:
t-PA vs. Placebo
1o Endpoint t-PA:
Death, MI, Rec Isch,
+ ETT, Thallium
or ST Holter
TIMI IIIB
Protocol Design
TIMI IIIB Investigators. Circulation 1994;89:1545-56
TIMI IIIB
tPA vs. Placebo in Non-ST Elevation ACS
Primary Results
Composite Endpoint

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