Thrombolysis in Myocardial Ischemia Trial (TIMI III)

Summary

The Thrombolysis in Myocardial Ischemia Trial (TIMI III) focused on unstable angina and non-Q-wave myocardial infarction. The trial was designed to determine by coronary arteriography the incidence of coronary thrombi in these conditions and the response of these thrombi to tissue-type plasminogen activator (t-PA) in TIMI IIIA and the effects of thrombolytic therapy and of an early invasive strategy on clinical outcome in TIMI IIIB. There was also a registry with two components. A roster enumerated all patients with unstable angina or non-Q-wave myocardial infarction enrolled at cooperating hospitals. From the roster, a study population of 1,893 subjects was selected and followed prospectively for the year to determine incidence of death or myocardial infarction.

Timeline

Start

1989-04

Primary completion

—

Completion

1995-06

Publications

• Background Williams DO, Braunwald E, Thompson B, Sharaf BL, Buller CE, Knatterud GL. Results of percutaneous transluminal coronary angioplasty in unstable angina and non-Q-wave myocardial infarction. Observations from the TIMI IIIB Trial. Circulation. 1996 Dec 1;94(11):2749-55. doi: 10.1161/01.cir.94.11.2749.
• Background Early effects of tissue-type plasminogen activator added to conventional therapy on the culprit coronary lesion in patients presenting with ischemic cardiac pain at rest. Results of the Thrombolysis in Myocardial Ischemia (TIMI IIIA) Trial. Circulation. 1993 Jan;87(1):38-52. doi: 10.1161/01.cir.87.1.38.
• Background Effects of tissue plasminogen activator and a comparison of early invasive and conservative strategies in unstable angina and non-Q-wave myocardial infarction. Results of the TIMI IIIB Trial. Thrombolysis in Myocardial Ischemia. Circulation. 1994 Apr;89(4):1545-56. doi: 10.1161/01.cir.89.4.1545.
• Background Diver DJ, Bier JD, Ferreira PE, Sharaf BL, McCabe C, Thompson B, Chaitman B, Williams DO, Braunwald E. Clinical and arteriographic characterization of patients with unstable angina without critical coronary arterial narrowing (from the TIMI-IIIA Trial). Am J Cardiol. 1994 Sep 15;74(6):531-7. doi: 10.1016/0002-9149(94)90739-0.
• Background Cannon CP, Thompson B, McCabe CH, Mueller HS, Kirshenbaum JM, Herson S, Nasmith JB, Chaitman BR, Braunwald E. Predictors of non-Q-wave acute myocardial infarction in patients with acute ischemic syndromes: an analysis from the Thrombolysis in Myocardial Ischemia (TIMI) III trials. Am J Cardiol. 1995 May 15;75(15):977-81. doi: 10.1016/s0002-9149(99)80707-3.
• Background Anderson HV, Cannon CP, Stone PH, Williams DO, McCabe CH, Knatterud GL, Thompson B, Willerson JT, Braunwald E. One-year results of the Thrombolysis in Myocardial Infarction (TIMI) IIIB clinical trial. A randomized comparison of tissue-type plasminogen activator versus placebo and early invasive versus early conservative strategies in unstable angina and non-Q wave myocardial infarction. J Am Coll Cardiol. 1995 Dec;26(7):1643-50. doi: 10.1016/0735-1097(95)00404-1.
• Background Becker RC, Cannon CP, Tracy RP, Thompson B, Bovill EG, Desvigne-Nickens P, Randall AM, Knatternud G, Braunwald E. Relation between systemic anticoagulation as determined by activated partial thromboplastin time and heparin measurements and in-hospital clinical events in unstable angina and non-Q wave myocardiaL infarction. Thrombolysis in Myocardial Ischemia III B Investigators. Am Heart J. 1996 Mar;131(3):421-33. doi: 10.1016/s0002-8703(96)90519-0.
• Background Stone PH, Thompson B, Anderson HV, Kronenberg MW, Gibson RS, Rogers WJ, Diver DJ, Theroux P, Warnica JW, Nasmith JB, Kells C, Kleiman N, McCabe CH, Schactman M, Knatterud GL, Braunwald E. Influence of race, sex, and age on management of unstable angina and non-Q-wave myocardial infarction: The TIMI III registry. JAMA. 1996 Apr 10;275(14):1104-12.
• Background Kleiman NS, Anderson HV, Rogers WJ, Theroux P, Thompson B, Stone PH. Comparison of outcome of patients with unstable angina and non-Q-wave acute myocardial infarction with and without prior coronary artery bypass grafting (Thrombolysis in Myocardial Ischemia III Registry). Am J Cardiol. 1996 Feb 1;77(4):227-31. doi: 10.1016/s0002-9149(97)89383-6.
• Background Becker RC, Cannon CP, Bovill EG, Tracy RP, Thompson B, Knatterud GL, Randall A, Braunwald B. Prognostic value of plasma fibrinogen concentration in patients with unstable angina and non-Q-wave myocardial infarction (TIMI IIIB Trial). Am J Cardiol. 1996 Jul 15;78(2):142-7. doi: 10.1016/s0002-9149(96)90386-0.
• Background Cannon CP, McCabe CH, Stone PH, Schactman M, Thompson B, Theroux P, Gibson RS, Feldman T, Kleiman NS, Tofler GH, Muller JE, Chaitman BR, Braunwald E. Circadian variation in the onset of unstable angina and non-Q-wave acute myocardial infarction (the TIMI III Registry and TIMI IIIB). Am J Cardiol. 1997 Feb 1;79(3):253-8. doi: 10.1016/s0002-9149(97)00743-1.
• Background Bovill EG, Tracy RP, Knatterud GL, Stone PH, Nasmith J, Gore JM, Thompson BW, Tofler GH, Kleiman NS, Cannon C, Braunwald E. Hemorrhagic events during therapy with recombinant tissue plasminogen activator, heparin, and aspirin for unstable angina (Thrombolysis in Myocardial Ischemia, phase IIIB trial). Am J Cardiol. 1997 Feb 15;79(4):391-6. doi: 10.1016/s0002-9149(96)00773-4.
• Background Cannon CP, McCabe CH, Stone PH, Rogers WJ, Schactman M, Thompson BW, Pearce DJ, Diver DJ, Kells C, Feldman T, Williams M, Gibson RS, Kronenberg MW, Ganz LI, Anderson HV, Braunwald E. The electrocardiogram predicts one-year outcome of patients with unstable angina and non-Q wave myocardial infarction: results of the TIMI III Registry ECG Ancillary Study. Thrombolysis in Myocardial Ischemia. J Am Coll Cardiol. 1997 Jul;30(1):133-40. doi: 10.1016/s0735-1097(97)00160-5.
• Background Hochman JS, McCabe CH, Stone PH, Becker RC, Cannon CP, DeFeo-Fraulini T, Thompson B, Steingart R, Knatterud G, Braunwald E. Outcome and profile of women and men presenting with acute coronary syndromes: a report from TIMI IIIB. TIMI Investigators. Thrombolysis in Myocardial Infarction. J Am Coll Cardiol. 1997 Jul;30(1):141-8. doi: 10.1016/s0735-1097(97)00107-1.
• Background Anderson HV, Gibson RS, Stone PH, Cannon CP, Aguirre F, Thompson B, Knatterud GL, Braunwald E. Management of unstable angina pectoris and non-Q-wave acute myocardial infarction in the United States and Canada (the TIMI III Registry). Am J Cardiol. 1997 Jun 1;79(11):1441-6. doi: 10.1016/s0002-9149(97)00168-9.
• Background Jain D, Thompson B, Wackers FJ, Zaret BL. Relevance of increased lung thallium uptake on stress imaging in patients with unstable angina and non-Q wave myocardial infarction: results of the Thrombolysis in Myocardial Infarction (TIMI)-IIIB Study. J Am Coll Cardiol. 1997 Aug;30(2):421-9. doi: 10.1016/s0735-1097(97)00164-2.
• Background Stone PH, Thompson B, Zaret BL, Chaitman B, Gibson RS, Schweiger MJ, Steingart R, Kirshenbaum J, Thompson C, Fung A, McCabe CH, Knatterud GL, Braunwald E. Factors associated with failure of medical therapy in patients with unstable angina and non-Q wave myocardial infarction. A TIMI-IIIB database study. Eur Heart J. 1999 Aug;20(15):1084-93. doi: 10.1053/euhj.1998.1480.
• Brewster LM, Fernand J. Creatine kinase during non-ST-segment elevation acute coronary syndromes is associated with major bleeding. Open Heart. 2020 Dec;7(2):e001281. doi: 10.1136/openhrt-2020-001281.

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