Author(s) |
ADVANCE MI Investigators
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Title(s) |
Facilitated percutaneous coronary intervention for acute ST-segment elevation myocardial infarction: Results from the prematurely terminated ADdressing the Value of facilitated ANgioplasty after Combination therapy or Eptifibatide monotherapy in acute Myocardial Infarction (ADVANCE MI) trial |
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Reference(s) |
Am Heart J 2005;150:116–22 |
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Disease |
AMI |
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Purpose |
To evaluate the effects of administering eptifibatide plus reduced-dose tenecteplase before percutaneous coronary intervention |
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Study design |
Randomised, double-blind, placebo-controlled, 2 x 2 factorial |
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Follow-up |
30 days |
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Patients |
148 patients (74 eptifibatide plus tenecteplase, 74 eptifibatide alone), aged > 18 years, with ST-segment elevation MI, undergoing percutaneous coronary intervention. Time since onset of symptoms: < 6 h |
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Treatment regimen |
Eptifibatide, 180 µg/kg iv bolus, then 2 µg/kg/min iv infusion, then 180 µg/kg iv bolus 10 min after first bolus, plus tenecteplase, 0.25 mg/kg iv bolus, or eptifibatide plus placebo. All doses were reduced by approximately 25% in patients aged ≥ 75 years |
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Concomitant therapy |
ASA, clopidogrel, and either unfractionated heparin or enoxaparin |
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Results |
The incidence of the combined primary endpoint of death or severe congestive heart failure was 11% in patients treated with eptifibatide plus tenecteplase and 1% in those treated with eptifibatide alone (p = 0.02). Bleeding complications were significantly higher in the group receiving eptifibatide plus tenecteplase than in the eptifibatide-only group |
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Comments |
Enrolment was stopped prematurely at 148 patients (aim was 5640 patients) because it was determined that the trial would not be completed within a reasonable time frame |
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