PMID- 14563573
OWN - NLM
STAT- MEDLINE
DCOM- 20031107
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 42
IP  - 8
DP  - 2003 Oct 15
TI  - 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.
PG  - 1348-56
AB  - 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.
FAU - Cohen, Marc
AU  - Cohen M
AD  - Newark Beth Israel Medical Center, Newark, New Jersey 07112, USA. 
      marcohen@sbhcs.com
FAU - Gensini, Gian Franco
AU  - Gensini GF
FAU - Maritz, Frans
AU  - Maritz F
FAU - Gurfinkel, Enrique P
AU  - Gurfinkel EP
FAU - Huber, Kurt
AU  - Huber K
FAU - Timerman, Ari
AU  - Timerman A
FAU - Krzeminska-Pakula, Maria
AU  - Krzeminska-Pakula M
FAU - Danchin, Nicolas
AU  - Danchin N
FAU - White, Harvey D
AU  - White HD
FAU - Santopinto, Jose
AU  - Santopinto J
FAU - Bigonzi, Frederique
AU  - Bigonzi F
FAU - Hecquet, Carole
AU  - Hecquet C
FAU - Vittori, Luc
AU  - Vittori L
CN  - TETAMI Investigators
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 42HK56048U (Tyrosine)
RN  - 9005-49-6 (Heparin)
RN  - GGX234SI5H (Tirofiban)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
CIN - J Am Coll Cardiol. 2003 Oct 15;42(8):1357-9. PMID: 14563574
MH  - Administration, Oral
MH  - Aspirin/administration & dosage/therapeutic use
MH  - Double-Blind Method
MH  - Drug Therapy, Combination
MH  - Electrocardiography
MH  - Enoxaparin/administration & dosage/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/administration & dosage/*therapeutic use
MH  - Heparin/administration & dosage/*therapeutic use
MH  - Humans
MH  - Incidence
MH  - Injections, Intravenous
MH  - Injections, Subcutaneous
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/mortality
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
MH  - Recurrence
MH  - Time Factors
MH  - Tirofiban
MH  - Tyrosine/administration & dosage/analogs & derivatives/*therapeutic use
EDAT- 2003/10/18 05:00
MHDA- 2003/11/08 05:00
CRDT- 2003/10/18 05:00
PHST- 2003/10/18 05:00 [pubmed]
PHST- 2003/11/08 05:00 [medline]
PHST- 2003/10/18 05:00 [entrez]
AID - S0735109703010404 [pii]
AID - 10.1016/s0735-1097(03)01040-4 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2003 Oct 15;42(8):1348-56. doi: 10.1016/s0735-1097(03)01040-4.