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A randomized trial comparing primary angioplasty with a strategy of short-acting thrombolysis and immediate planned rescue angioplasty in acute myocardial infarction: the PACT trial

Allan M. Ross, MD, FACC^*, Karin S. Coyne, PhD, RN, MPH^*, Jonathan S. Reiner, MD, FACC^*, Samuel W. Greenhouse, PhD, Cynthia Fink, MPH^*, Anthony Frey, MD^*, Eduardo Moreyra, MD, FACC^*, Mouhieddin Traboulsi, MD, FACC, Normand Racine, MD, Arthur L. Riba, MD, FACC^||, Mark A. Thompson, MD, FACC^¶, Steven Rohrbeck, MD, FACC^#, Conor F. Lundergan, MD^* for the PACT Investigators

^* Cardiovascular Research Institute of George Washington University, Washington, DC, USA
The Biostatistics Center of George Washington University, Washington, DC, USA
Foothills Hospital, Calgary, Alberta, Canada
Hospital Notre Dame, Montreal, Quebec, Canada
^|| Oakwood Hospital, Dearborn, Michigan, USA
^¶ Rochester General Hospital, Rochester, New York, USA
^# High Point Regional Hospital, High Point, North Carolina, USA

View larger version (15K): [in a new window]   Figure 1 Schematic of trial design. ASA = aspirin; IV = intravenous; rt-PA = recombinant tissue-type plasminogen activator; TIMI = Thrombolysis in Myocardial Infarction trial.

View larger version (24K): [in a new window]   Figure 2 Infarct-related artery patency at time of initial coronary angiography. All treatment group comparisons p < 0.001.

View larger version (14K): [in a new window]   Figure 3 Cumulative frequency distribution of time to TIMI flow grade 3 in patients with (n = 319) and without (n = 141) angioplasty at time of initial angiography. Patients with less than TIMI flow grade 3 (n = 133) are not included in the frequency distributions.