JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2006; 47:2364-2373, doi:10.1016/j.jacc.2005.12.077
© 2006 by the American College of Cardiology Foundation
This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow View Online Appendix
Right arrow View Online Video
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (18)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gibson, C. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gibson, C. M.
Related Collections
Right arrowRelated Article

A Randomized Trial to Evaluate the Relative Protection Against Post-Percutaneous Coronary Intervention Microvascular Dysfunction, Ischemia, and Inflammation Among Antiplatelet and Antithrombotic Agents

The PROTECT–TIMI-30 Trial

C. Michael Gibson, MS, MD*,3,*, David A. Morrow, MD, MPH*, Sabina A. Murphy, MPH*, Theresa M. Palabrica, MD{dagger},1, Lisa K. Jennings, PhD{ddagger},4, Peter H. Stone, MD*, Henry H. Lui, MD§, Thomas Bulle, MD||, Nasser Lakkis, MD, Richard Kovach, MD#, David J. Cohen, MD, MSC**,2, Polly Fish, BS*, Carolyn H. McCabe, BS*, Eugene Braunwald, MD* for the TIMI Study Group

* TIMI Study Group, Cardiovascular Division, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, Massachusetts
{dagger} Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts
{ddagger} University of Tennessee, Knoxville, Tennessee
§ APEX Cardiology, Jackson, Tennessee
|| Cardiovascular Associates, Kingsport, Tennessee
Ben Taub Hospital, Houston, Texas
# Our Lady of Lourdes Medical Center, Camden, New Jersey
** Beth Israel Deaconess Medical Center, Boston, Massachusetts.


Figure 1
View larger version (38K):

[in a new window]
  		Figure 1 Design of the PROTECT–TIMI-30 trial. ACT = activated clotting time; d/c = discontinued; IV = intravenous; IVB = intravenous bolus; PCI = percutaneous coronary intervention; UFH = unfractionated heparin.

 

Figure 2
View larger version (18K):

[in a new window]
  		Figure 2 Among angiographically evaluable patients, the median coronary flow reserve was greater in the bivalirudin arm.

 

Figure 3
View larger version (19K):

[in a new window]
  		Figure 3 The Thrombolysis In Myocardial Infarction myocardial perfusion grade (TMPG) 3 after percutaneous coronary intervention (PCI). The frequency of TMPG 3 after PCI was significantly greater in the eptifibatide group compared with the bivalirudin group. The p value has been adjusted for the pre-PCI TMPG 3 as prespecified. The univariate p = 0.074.

 

Figure 4
View larger version (20K):

[in a new window]
  		Figure 4 Incidence and duration of ischemia on Holter monitoring after percutaneous coronary intervention. Among patients with an ischemic event after percutaneous coronary intervention, the median duration of ischemia was significantly longer in the bivalirudin group compared with the eptifibatide group.

 

Figure 5
View larger version (17K):

[in a new window]
  		Figure 5 Death (D), myocardial infarction (MI), or ischemia on Holter monitoring through 48 h. The composite event of D, MI, or ischemia on Holter monitoring through 48 h occurred in 18% of the bivalirudin arm compared with 14.2% of the pooled eptifibatide arms (odds ratio [OR] 1.35, 95% confidence interval [CI] 0.91 to 2.01, p = 0.150), whereas the composite of D or MI occurred in 8.8% and 6.6%, respectively (OR 1.37, 95% CI 0.81 to 2.31, p = 0.246). One patient in the eptifibatide arm died outside of the 48-h window (at 3 days after randomization) secondary to a retroperitoneal bleed.

 

Figure 6
View larger version (9K):

[in a new window]
  		Figure 6 Incidence of Thrombolysis In Myocardial Infarction (TIMI) major hemorrhage. The rate of TIMI major hemorrhage, the primary safety end point, did not differ between the eptifibatide (EPT, pooled) and bivalirudin (BIV) treatment groups. ENOX = reduced-dose enoxaparin.

 

Figure 7
View larger version (13K):

[in a new window]
  		Figure 7 Incidence of transfusion. The rate of transfusion occurred significantly more frequently in the eptifibatide (EPT) arms compared with the bivalirudin (BIV) treatment group. ENOX =reduced-dose enoxaparin; UFH = unfractionated heparin.

 




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2006 by the American College of Cardiology Foundation.