GUSTO IIb angioplasty subset trial

1138 patients presenting within 12 hours of acute myocardial infarction were randomized to primary angioplasty or accelerated thrombolytic therapy with recombinant tissue plasminogen activator.

1012 patients were also randomized to heparin or hirudin treatment in a factorial design.

The primary study end point was a composite outcome of death, nonfatal reinfarction, and nonfatal disabling stroke at 30 days.

The authors concluded that there was a moderate improvement in short-term outcomes in the acute angioplasty group. There was no significant improvement in outcome at six months.

Reference:

• 1) GUSTO IIb Angioplasty Substudy Investigators (1997). A clinical trial comparing primary coronary angioplasty with tissue plasminogen activator for acute myocardial infarction. The Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) Angioplasty Substudy Investigators. New England Journal of Medicine 336(23): 1621-8.