Combination reperfusion therapy with abciximab and reduced dose reteplase

Results from TIMI 14

Elliot M. Antman, C. M. Gibson, James A de Lemos, R. P. Giugliano, C. H. McCabe, P. Coussement, I. Menown, C. A. Nienaber, T. C. Rehders, M. J. Frey, R. Van Der Wieken, D. Andresen, J. Scherer, K. Anderson, F. Van De Werf, E. Braunwald

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Aims Abciximab has previously been shown to enhance thrombolysis and improve myocardial perfusion when combined with reduced doses of alteplase. The purpose of the reteplase phase of TIMI 14 was to evaluate the effects of abciximab when used in combination with a reduced dose of reteplase for ST-elevation myocardial infarction. Methods and Results Patients (n=299) with ST-elevation myocardial infarction were treated with aspirin and randomized to a control arm with standard dose reteplase (10+10 U given 30 min apart) or abciximab (bolus of 0.25 mg . kg-1 and 12-h infusion of 0.125 μg . kg-1 . min-1) in combination with reduced doses of reteplase (5+5 U or 10+5 U). Control patients received standard weight-adjusted heparin (bolus of 70 U . kg-1; infusion of 15 U . kg-1 . h-1), while each of the combination arms with abciximab and reduced dose reteplase received either low dose heparin (bolus of 60 U . kg-1; infusion of 7 U . kg-1 . h-1) or very low dose heparin (bolus of 30 U . kg-1; infusion of 4 U . kg-1 . h-1). The rate of TIMI 3 flow at 90 min was 70% for patients treated with 10+10 U of reteplase alone (n=87), 73% for those treated with 5+5 U of reteplase with abciximab (n=88), and 77% for those treated with 10+5 U of reteplase with abciximab (n=75). Complete (≥70%) ST resolution at 90 min was seen in 56% of patients receiving a reduced dose of reteplase in combination with abciximab compared with 48% of patients receiving reteplase alone. Conclusions Reduced doses of reteplase when administered in combination with abciximab were associated with higher TIMI 3 flow rates than reported previously for reduced doses of reteplase without abciximab and were at least as high as for full dose reteplase alone. (C) 2000 The European Society of Cardiology.

Original languageEnglish (US)
Pages (from-to)1944-1953
Number of pages10
JournalEuropean Heart Journal
Volume21
Issue number23
StatePublished - 2000

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Reperfusion
Therapeutics
Heparin
reteplase
abciximab
Tissue Plasminogen Activator
Aspirin
Perfusion
Weights and Measures

Keywords

  • Acute MI
  • Antiplatelet therapy
  • Glycoprotein IIb/IIIa inhibition
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Antman, E. M., Gibson, C. M., de Lemos, J. A., Giugliano, R. P., McCabe, C. H., Coussement, P., ... Braunwald, E. (2000). Combination reperfusion therapy with abciximab and reduced dose reteplase: Results from TIMI 14. European Heart Journal, 21(23), 1944-1953.

Combination reperfusion therapy with abciximab and reduced dose reteplase : Results from TIMI 14. / Antman, Elliot M.; Gibson, C. M.; de Lemos, James A; Giugliano, R. P.; McCabe, C. H.; Coussement, P.; Menown, I.; Nienaber, C. A.; Rehders, T. C.; Frey, M. J.; Van Der Wieken, R.; Andresen, D.; Scherer, J.; Anderson, K.; Van De Werf, F.; Braunwald, E.

In: European Heart Journal, Vol. 21, No. 23, 2000, p. 1944-1953.

Research output: Contribution to journalArticle

Antman, EM, Gibson, CM, de Lemos, JA, Giugliano, RP, McCabe, CH, Coussement, P, Menown, I, Nienaber, CA, Rehders, TC, Frey, MJ, Van Der Wieken, R, Andresen, D, Scherer, J, Anderson, K, Van De Werf, F & Braunwald, E 2000, 'Combination reperfusion therapy with abciximab and reduced dose reteplase: Results from TIMI 14', European Heart Journal, vol. 21, no. 23, pp. 1944-1953.
Antman EM, Gibson CM, de Lemos JA, Giugliano RP, McCabe CH, Coussement P et al. Combination reperfusion therapy with abciximab and reduced dose reteplase: Results from TIMI 14. European Heart Journal. 2000;21(23):1944-1953.
Antman, Elliot M. ; Gibson, C. M. ; de Lemos, James A ; Giugliano, R. P. ; McCabe, C. H. ; Coussement, P. ; Menown, I. ; Nienaber, C. A. ; Rehders, T. C. ; Frey, M. J. ; Van Der Wieken, R. ; Andresen, D. ; Scherer, J. ; Anderson, K. ; Van De Werf, F. ; Braunwald, E. / Combination reperfusion therapy with abciximab and reduced dose reteplase : Results from TIMI 14. In: European Heart Journal. 2000 ; Vol. 21, No. 23. pp. 1944-1953.
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abstract = "Aims Abciximab has previously been shown to enhance thrombolysis and improve myocardial perfusion when combined with reduced doses of alteplase. The purpose of the reteplase phase of TIMI 14 was to evaluate the effects of abciximab when used in combination with a reduced dose of reteplase for ST-elevation myocardial infarction. Methods and Results Patients (n=299) with ST-elevation myocardial infarction were treated with aspirin and randomized to a control arm with standard dose reteplase (10+10 U given 30 min apart) or abciximab (bolus of 0.25 mg . kg-1 and 12-h infusion of 0.125 μg . kg-1 . min-1) in combination with reduced doses of reteplase (5+5 U or 10+5 U). Control patients received standard weight-adjusted heparin (bolus of 70 U . kg-1; infusion of 15 U . kg-1 . h-1), while each of the combination arms with abciximab and reduced dose reteplase received either low dose heparin (bolus of 60 U . kg-1; infusion of 7 U . kg-1 . h-1) or very low dose heparin (bolus of 30 U . kg-1; infusion of 4 U . kg-1 . h-1). The rate of TIMI 3 flow at 90 min was 70{\%} for patients treated with 10+10 U of reteplase alone (n=87), 73{\%} for those treated with 5+5 U of reteplase with abciximab (n=88), and 77{\%} for those treated with 10+5 U of reteplase with abciximab (n=75). Complete (≥70{\%}) ST resolution at 90 min was seen in 56{\%} of patients receiving a reduced dose of reteplase in combination with abciximab compared with 48{\%} of patients receiving reteplase alone. Conclusions Reduced doses of reteplase when administered in combination with abciximab were associated with higher TIMI 3 flow rates than reported previously for reduced doses of reteplase without abciximab and were at least as high as for full dose reteplase alone. (C) 2000 The European Society of Cardiology.",
keywords = "Acute MI, Antiplatelet therapy, Glycoprotein IIb/IIIa inhibition, Thrombolysis",
author = "Antman, {Elliot M.} and Gibson, {C. M.} and {de Lemos}, {James A} and Giugliano, {R. P.} and McCabe, {C. H.} and P. Coussement and I. Menown and Nienaber, {C. A.} and Rehders, {T. C.} and Frey, {M. J.} and {Van Der Wieken}, R. and D. Andresen and J. Scherer and K. Anderson and {Van De Werf}, F. and E. Braunwald",
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TY - JOUR

T1 - Combination reperfusion therapy with abciximab and reduced dose reteplase

T2 - Results from TIMI 14

AU - Antman, Elliot M.

AU - Gibson, C. M.

AU - de Lemos, James A

AU - Giugliano, R. P.

AU - McCabe, C. H.

AU - Coussement, P.

AU - Menown, I.

AU - Nienaber, C. A.

AU - Rehders, T. C.

AU - Frey, M. J.

AU - Van Der Wieken, R.

AU - Andresen, D.

AU - Scherer, J.

AU - Anderson, K.

AU - Van De Werf, F.

AU - Braunwald, E.

PY - 2000

Y1 - 2000

N2 - Aims Abciximab has previously been shown to enhance thrombolysis and improve myocardial perfusion when combined with reduced doses of alteplase. The purpose of the reteplase phase of TIMI 14 was to evaluate the effects of abciximab when used in combination with a reduced dose of reteplase for ST-elevation myocardial infarction. Methods and Results Patients (n=299) with ST-elevation myocardial infarction were treated with aspirin and randomized to a control arm with standard dose reteplase (10+10 U given 30 min apart) or abciximab (bolus of 0.25 mg . kg-1 and 12-h infusion of 0.125 μg . kg-1 . min-1) in combination with reduced doses of reteplase (5+5 U or 10+5 U). Control patients received standard weight-adjusted heparin (bolus of 70 U . kg-1; infusion of 15 U . kg-1 . h-1), while each of the combination arms with abciximab and reduced dose reteplase received either low dose heparin (bolus of 60 U . kg-1; infusion of 7 U . kg-1 . h-1) or very low dose heparin (bolus of 30 U . kg-1; infusion of 4 U . kg-1 . h-1). The rate of TIMI 3 flow at 90 min was 70% for patients treated with 10+10 U of reteplase alone (n=87), 73% for those treated with 5+5 U of reteplase with abciximab (n=88), and 77% for those treated with 10+5 U of reteplase with abciximab (n=75). Complete (≥70%) ST resolution at 90 min was seen in 56% of patients receiving a reduced dose of reteplase in combination with abciximab compared with 48% of patients receiving reteplase alone. Conclusions Reduced doses of reteplase when administered in combination with abciximab were associated with higher TIMI 3 flow rates than reported previously for reduced doses of reteplase without abciximab and were at least as high as for full dose reteplase alone. (C) 2000 The European Society of Cardiology.

AB - Aims Abciximab has previously been shown to enhance thrombolysis and improve myocardial perfusion when combined with reduced doses of alteplase. The purpose of the reteplase phase of TIMI 14 was to evaluate the effects of abciximab when used in combination with a reduced dose of reteplase for ST-elevation myocardial infarction. Methods and Results Patients (n=299) with ST-elevation myocardial infarction were treated with aspirin and randomized to a control arm with standard dose reteplase (10+10 U given 30 min apart) or abciximab (bolus of 0.25 mg . kg-1 and 12-h infusion of 0.125 μg . kg-1 . min-1) in combination with reduced doses of reteplase (5+5 U or 10+5 U). Control patients received standard weight-adjusted heparin (bolus of 70 U . kg-1; infusion of 15 U . kg-1 . h-1), while each of the combination arms with abciximab and reduced dose reteplase received either low dose heparin (bolus of 60 U . kg-1; infusion of 7 U . kg-1 . h-1) or very low dose heparin (bolus of 30 U . kg-1; infusion of 4 U . kg-1 . h-1). The rate of TIMI 3 flow at 90 min was 70% for patients treated with 10+10 U of reteplase alone (n=87), 73% for those treated with 5+5 U of reteplase with abciximab (n=88), and 77% for those treated with 10+5 U of reteplase with abciximab (n=75). Complete (≥70%) ST resolution at 90 min was seen in 56% of patients receiving a reduced dose of reteplase in combination with abciximab compared with 48% of patients receiving reteplase alone. Conclusions Reduced doses of reteplase when administered in combination with abciximab were associated with higher TIMI 3 flow rates than reported previously for reduced doses of reteplase without abciximab and were at least as high as for full dose reteplase alone. (C) 2000 The European Society of Cardiology.

KW - Acute MI

KW - Antiplatelet therapy

KW - Glycoprotein IIb/IIIa inhibition

KW - Thrombolysis

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M3 - Article

VL - 21

SP - 1944

EP - 1953

JO - European Heart Journal

JF - European Heart Journal

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