The safety and efficacy of subcutaneous enoxaparin versus intravenous unfractionated heparin and tirofiban versus placebo in the treatment of acute ST-segment elevation myocardial infarction patients ineligible for reperfusion (TETAMI): a randomized trial.

Content Provider	Semantic Scholar
Author	Cohen, Marc Gensini, Gian Franco Maritz, Frans Jacobus Gurfinkel, Enrique P. Huber, K. K. G. Timerman, Ari Krzeminska-Pakula, Maria Danchin, Nicolas White, Harvey D. Santopinto, José Bigonzi, Frederique Hecquet, Carole A. Vittori, Luc
Copyright Year	2003
Abstract	OBJECTIVES The aims of the Safety and Efficacy of Subcutaneous Enoxaparin Versus Intravenous Unfractionated Heparin and Tirofiban Versus Placebo in the Treatment of Acute ST-Segment Elevation Myocardial Infarction Patients Ineligible for Reperfusion (TETAMI) study were to demonstrate that enoxaparin was superior to unfractionated heparin (UFH) and that tirofiban was better than placebo in patients with acute ST-segment elevation myocardial infarction (STEMI) who do not receive timely reperfusion. BACKGROUND An optimal treatment strategy has not been identified for the many STEMI patients ineligible for acute reperfusion. METHODS A total of 1224 patients were enrolled in 91 centers in 14 countries between July 1999 and July 2002. Patients with STEMI ineligible for reperfusion were randomized to enoxaparin, enoxaparin plus tirofiban, UFH, or UFH plus tirofiban. All patients received oral aspirin. The primary efficacy end point was the 30-day combined incidence of death, reinfarction, or recurrent angina; the primary analysis was the comparison of the pooled enoxaparin and UFH groups. RESULTS The incidence of the primary efficacy end point was 15.7% enoxaparin versus 17.3% for UFH (odds ratio 0.89 [95% confidence interval CI = 0.66 to 1.21]) and 16.6% for tirofiban versus 16.4% for placebo (odds ratio 1.02 [95% CI 0.75 to 1.38]). The Thrombolysis In Myocardial Infarction (TIMI) major hemorrhage rate was 1.5% for enoxaparin versus 1.3% for UFH (odds ratio 1.16 [95% CI 0.44 to 3.02]) and 1.8% versus 1% for tirofiban versus placebo (odds ratio 1.82 [95% CI 0.67 to 4.95]). CONCLUSIONS This study did not show that enoxaparin significantly reduced the 30-day incidence of death, reinfarction, and recurrent angina compared with UFH in non-reperfused STEMI patients. However, enoxaparin appears to have a similar safety and efficacy profile to UFH and may be an alternative treatment. Additional therapy with tirofiban did not appear beneficial.
File Format	PDF HTM / HTML
DOI	10.1016/S0735-1097(03)01040-4
PubMed reference number	14563573
Journal	Medline
Volume Number	42
Issue Number	8
Alternate Webpage(s)	http://www.onlinejacc.org/content/accj/42/8/1348.full.pdf
Alternate Webpage(s)	https://doi.org/10.1016/S0735-1097%2803%2901040-4
Journal	Journal of the American College of Cardiology
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article