氯吡格雷作为心肌梗死溶栓疗法辅助再灌注治疗措施(CLARITY-TIMI)-28试验的设计和原理

作     者：Sabatine M.S. McCabe C.H. Gibson C.M. Cannon C.P. 任付先 

作者机构：Cardiovascular Division Brigham and Women’ s Hospital 75 Francis Street Boston MA 02115 United States 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第8期

页      码：21-21页

摘      要：Background: Although fibrinolysis is effective in improving outcomes in ST- elevation myocardial infarction(STEMI), failure to achieve reperfusion and/or reocclusion of the infarct- related artery occur in substantial proportions of patients during their index hospitalization and are associated with a significant increase in mortality. We hypothesize that the addition of clopidogrel to standard fibrinolytic therapy in patients with acute STEMI will improve reperfusion. Study design: CLARITY- TIMI 28 is a multicenter, international, randomized, double- blind, placebo- contro- lled trial designed to examine the efficacy and safety of clopidogrel when added to standard adjuvant therapy for fibrinolysis. The primary efficacy end point is the composite of an occluded infarct- related artery(defined as TIMI flow grade 0 or 1) on the predischarge angiogram or death or a recurrent myocardial infarction(MI) up to the start of coronary angiography. For subjects who do not undergo angiography, occurrence of death or recurrent MI by day 8 or by hospital discharge, whichever comes first, is used. The primary safety assessment is TIMI major bleeding. Secondary end points include ST resolution at 180 minutes and the clinical composite of death, MI, or recurrent ischemia. Substudies include analyses of biomarkers, DNA, continuous electrocardiogram monitoring, and initiation of treatment in the ambulance. Conclusions: CLARITY- TIMI 28 will help to define the role of clopidogrel as part of the pharmacologic reperfusion regimen for acute STEMI.

主 题 词：再灌注治疗 CLARITY-TIMI 心肌梗死溶栓 梗死相关动脉 溶栓疗法 冠状动脉造影 次要终点 血流分级 连续心电监测 临床死亡 

学科分类：1002[医学-临床医学类] 100201[100201] 10[医学] 

馆 藏 号：203101877...