Efficacy of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: one-year follow-up results of the assessment of the safety of a new thrombolytic-3 (ASSENT-3) randomized trial in acute myocardial infarction - 26/08/11
, John H Alexander, MD b, Kris Bogaerts c, Ann Belmans c, Lars Wallentin, MD, PhD d, Paul Armstrong, MD e, Jennifer A.A Adgey, MD f, Michal Tendera, MD g, Rafael Diaz, MD h, Leopoldo Soares-Piegas, MD, PhD i, Alec Vahanian, MD j, Christopher B Granger, MD b, Frans J Van De Werf, MD, PhD aAbstract |
Background |
In the ASsessment of the Safety of a New Thrombolytic 3 (ASSENT-3) study, full-dose tenecteplase plus enoxaparin or half-dose tenecteplase plus abciximab reduced the frequency of ischemic complications of acute myocardial infarction, when compared to full-dose tenecteplase plus unfractionated heparin. The aim of the present study was to determine the effect of these fibrinolytic regimens on 1-year mortality.
Methods and results |
Vital status at 1 year was available for 5942 patients (97.5%) of the 6095 initially enrolled in the study. At 1 year, 515 patients (8.7%) had died. Elderly or female patients and patients with low body weight, previous myocardial infarction, anterior wall myocardial infarction, and diabetes were at increased risk for death at 1 year. Mortality at 1 year was 7.9 % (n = 161) in the heparin group, 8.1% (n = 166) in the enoxaparin group, and 9.3% (n = 188) in the abciximab group (P = .226). Overall, pairwise comparisons did not show a significant difference among treatment regimens: relative risk 1.03 (95% CI 0.82–1.30) for enoxaparin versus heparin (P = .794) and relative risk 1.18 (95% CI 0.95–1.47) for abciximab versus heparin (P = .144). However, 1-year outcome tended to be worse with abciximab in diabetic patients.
Conclusion |
Mortality at 1 year after acute myocardial infarction remains high. Despite a reduction in ischemic complications after acute myocardial infarction with the use of full-dose tenecteplase plus enoxaparin or half-dose tenecteplase plus abciximab, mortality at 1 year was similar in these treatment groups.
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 | Guest Editor for this manuscript was Carl J. Pepine, MD, University of Florida College of Medicine, Gainesville, Fla. |
Vol 147 - N° 6
P. 993-998 - Giugno 2004 Ritorno al numero
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