title: Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trial.
abstract: The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trial was a randomized, multicenter study performed to determine whether immediate or elective (7 day) coronary angioplasty was preferable once infarct vessel recanalization had been confirmed. In addition, a major focus of the effort was to collect detailed information about the clinical course and outcome of all 386 patients entered into the trial, whether randomized or not. This article reports the major end points of acute and follow-up mortality, the incidence and timing of recurrent ischemic events and acute and convalescent infarct-vessel patency. The optimal timing of coronary angioplasty and intravenous tissue plasminogen activator (rt-PA) administration is discussed. The subsets of patients who: 1) were unsuccessfully treated with rt-PA; 2) had a minimal residual (less than 50%) lesion after rt-PA; or 3) underwent emergency coronary bypass surgery are presented. A current practical approach to acute intervention is extrapolated from the TAMI results.
mesh_terms: D000800:Angioplasty, Balloon; D006328:Cardiac Catheterization; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003331:Coronary Vessels; D004630:Emergencies; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011897:Random Allocation; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014654:Vascular Patency / Q000187:drug effects
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator