At a glance
ClinicalIndex Comparison Record- ✓Age ≥60 years
- ✓Symptom onset <3 hours before randomization
- ✓12-lead ECG diagnostic of acute STEMI: ≥2 mm ST-elevation across ≥2 contiguous precordial leads (V1-V6) or leads I and aVL with minimum combined total ≥4 mm ST-elevation; OR ≥2 mm ST-elevation in ≥2 contiguous inferior leads (II, III, aVF) with minimum combined total ≥4 mm ST-elevation
- ✕Expected PCI cannot be performed within 60 minutes of diagnosis or inability to arrive at catheterization laboratory within 3 hours
- ✕Prior CABG
- ✕Left bundle branch block or ventricular pacing
- ✕Cardiogenic shock (Killip Class 4)
Standardized by ClinicalIndex from the ClinicalTrials.gov record · verify against the source.
STrategic Reperfusion in Elderly Patients Early After Myocardial Infarction
In Brief
A Phase 4 clinical trial evaluating Tenecteplase, Clopidogrel, and 2 other interventions for Myocardial Infarction. Completed, enrolled 609 participants across 50 sites in 10 countries.
Detailed Summary
In patients ≥ 60yrs with acute ST-elevation myocardial infarction randomised within 3 hours of onset of symptoms the efficacy and safety of a strategy of early fibrinolytic treatment with half-dose tenecteplase and additional antiplatelet therapy with a loading dose of 300 mg clopidogrel, aspirin and coupled with antithrombin therapy followed by catheterisation within 6-24 hours or rescue coronary intervention as required, will be compared to a strategy of primary PCI with a P2Y12 antagonist and antithrombin treatment according to local standards.
Study Details
Timeline
Interventions
Half dose Tenecteplase
300 mg p.o. initial loading dose. Maintenance dose of 75 mg p.o. once daily. The maintenance dose of Clopidogrel (75 mg p.o. per day) should be continued for 1 year.
Coronary angiography followed by PCI or CABG if required, rescue PCI if required
Primary PCI accoring to local standards