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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.

Publication ,  Journal Article
Sinnaeve, PR; Alexander, JH; Bogaerts, K; Belmans, A; Wallentin, L; Armstrong, P; Adgey, JAA; Tendera, M; Diaz, R; Soares-Piegas, L ...
Published in: Am Heart J
June 2004

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.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

June 2004

Volume

147

Issue

6

Start / End Page

993 / 998

Location

United States

Related Subject Headings

  • Tissue Plasminogen Activator
  • Tenecteplase
  • Survival Rate
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Injections, Subcutaneous
  • Injections, Intravenous
  • Infusions, Intravenous
  • Immunoglobulin Fab Fragments
 

Citation

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Sinnaeve, P. R., Alexander, J. H., Bogaerts, K., Belmans, A., Wallentin, L., Armstrong, P., … Van De Werf, F. J. (2004). 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. Am Heart J, 147(6), 993–998. https://doi.org/10.1016/j.ahj.2003.12.028
Sinnaeve, Peter R., John H. Alexander, Kris Bogaerts, Ann Belmans, Lars Wallentin, Paul Armstrong, Jennifer A. A. Adgey, et al. “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.Am Heart J 147, no. 6 (June 2004): 993–98. https://doi.org/10.1016/j.ahj.2003.12.028.
Sinnaeve PR, Alexander JH, Bogaerts K, Belmans A, Wallentin L, Armstrong P, Adgey JAA, Tendera M, Diaz R, Soares-Piegas L, Vahanian A, Granger CB, Van De Werf FJ. 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. Am Heart J. 2004 Jun;147(6):993–998.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

June 2004

Volume

147

Issue

6

Start / End Page

993 / 998

Location

United States

Related Subject Headings

  • Tissue Plasminogen Activator
  • Tenecteplase
  • Survival Rate
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Injections, Subcutaneous
  • Injections, Intravenous
  • Infusions, Intravenous
  • Immunoglobulin Fab Fragments