Thrombolysis in Myocardial Infarction (TIMI)

Summary

In TIMI I, to assess the relative thrombolytic activity and side effects of intravenous recombinant tissue-type plasminogen activator (rt-PA) versus intravenous streptokinase in patients with acute myocardial infarction. In TIMI II, to assess whether intravenous rt-PA given in the early hours of acute myocardial infarction should be followed by percutaneous transluminal coronary angioplasty (PTCA).

Timeline

Start

1983-04

Primary completion

—

Completion

1990-12

Publications

• Background TIMI Study Group. The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. N Engl J Med. 1985 Apr 4;312(14):932-6. doi: 10.1056/NEJM198504043121437. No abstract available.
• Background Hillis LD, Borer J, Braunwald E, Chesebro JH, Cohen LS, Dalen J, Dodge HT, Francis CK, Knatterud G, Ludbrook P, et al. High dose intravenous streptokinase for acute myocardial infarction: preliminary results of a multicenter trial. J Am Coll Cardiol. 1985 Nov;6(5):957-62. doi: 10.1016/s0735-1097(85)80294-1.
• Background Williams DO, Borer J, Braunwald E, Chesebro JH, Cohen LS, Dalen J, Dodge HT, Francis CK, Knatterud G, Ludbrook P, et al. Intravenous recombinant tissue-type plasminogen activator in patients with acute myocardial infarction: a report from the NHLBI thrombolysis in myocardial infarction trial. Circulation. 1986 Feb;73(2):338-46. doi: 10.1161/01.cir.73.2.338.
• Background Braunwald E, Knatterud GL, Passamani ER, Robertson TL. Announcement of protocol change in thrombolysis in myocardial infarction trial. J Am Coll Cardiol. 1987 Feb;9(2):467. doi: 10.1016/s0735-1097(87)80407-2. No abstract available.
• Background Sheehan FH, Braunwald E, Canner P, Dodge HT, Gore J, Van Natta P, Passamani ER, Williams DO, Zaret B. The effect of intravenous thrombolytic therapy on left ventricular function: a report on tissue-type plasminogen activator and streptokinase from the Thrombolysis in Myocardial Infarction (TIMI Phase I) trial. Circulation. 1987 Apr;75(4):817-29. doi: 10.1161/01.cir.75.4.817.
• Background Chesebro JH, Knatterud G, Roberts R, Borer J, Cohen LS, Dalen J, Dodge HT, Francis CK, Hillis D, Ludbrook P, et al. Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: A comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge. Circulation. 1987 Jul;76(1):142-54. doi: 10.1161/01.cir.76.1.142.
• Background Mueller HS, Rao AK, Forman SA. Thrombolysis in myocardial infarction (TIMI): comparative studies of coronary reperfusion and systemic fibrinogenolysis with two forms of recombinant tissue-type plasminogen activator. J Am Coll Cardiol. 1987 Sep;10(3):479-90. doi: 10.1016/s0735-1097(87)80188-2.
• Background Knatterud GL, Forman SA. Patient recruitment experience in the Thrombolysis in Myocardial Infarction Trial. Control Clin Trials. 1987 Dec;8(4 Suppl):86S-93S. doi: 10.1016/0197-2456(87)90011-0.
• Background Bovill E: Dose Response Relationship of rt-PA Infusion to Induction of Systemic Fibrin(ogen)olysis in the Thrombolysis in Myocardial Infarction (TIMI) Trial. Blood, 70(Suppl 1) 367a, 1987.
• Background Williams DO, Ruocco NA, Forman S. Coronary angioplasty after recombinant tissue-type plasminogen activator in acute myocardial infarction: a report from the Thrombolysis in Myocardial Infarction (TIMI) Trial. J Am Coll Cardiol. 1987 Nov;10(5 Suppl B):45B-50B. doi: 10.1016/s0735-1097(87)80428-x.
• Background Passamani E, Hodges M, Herman M, Grose R, Chaitman B, Rogers W, Forman S, Terrin M, Knatterud G, Robertson T, et al. The Thrombolysis in Myocardial Infarction (TIMI) phase II pilot study: tissue plasminogen activator followed by percutaneous transluminal coronary angioplasty. J Am Coll Cardiol. 1987 Nov;10(5 Suppl B):51B-64B. doi: 10.1016/s0735-1097(87)80429-1.
• Background Rao AK, Pratt C, Berke A, Jaffe A, Ockene I, Schreiber TL, Bell WR, Knatterud G, Robertson TL, Terrin ML. Thrombolysis in Myocardial Infarction (TIMI) Trial--phase I: hemorrhagic manifestations and changes in plasma fibrinogen and the fibrinolytic system in patients treated with recombinant tissue plasminogen activator and streptokinase. J Am Coll Cardiol. 1988 Jan;11(1):1-11. doi: 10.1016/0735-1097(88)90158-1.
• Background Immediate vs delayed catheterization and angioplasty following thrombolytic therapy for acute myocardial infarction. TIMI II A results. The TIMI Research Group. JAMA. 1988 Nov 18;260(19):2849-58. doi: 10.1001/jama.1988.03410190097031.
• Background Dalen JE, Gore JM, Braunwald E, Borer J, Goldberg RJ, Passamani ER, Forman S, Knatterud G. Six- and twelve-month follow-up of the phase I Thrombolysis in Myocardial Infarction (TIMI) trial. Am J Cardiol. 1988 Aug 1;62(4):179-85. doi: 10.1016/0002-9149(88)90208-1.
• Background Rogers WJ, Bourge RC, Papapietro SE, Wackers FJ, Zaret BL, Forman S, Dodge HT, Robertson TL, Passamani ER, Braunwald E, et al. Variables predictive of good functional outcome following thrombolytic therapy in the Thrombolysis in Myocardial Infarction phase II (TIMI II) pilot study. Am J Cardiol. 1989 Mar 1;63(9):503-12. doi: 10.1016/0002-9149(89)90889-8.
• Background Wackers FJ, Terrin ML, Kayden DS, Knatterud G, Forman S, Braunwald E, Zaret BL. Quantitative radionuclide assessment of regional ventricular function after thrombolytic therapy for acute myocardial infarction: results of phase I Thrombolysis in Myocardial Infarction (TIMI) trial. J Am Coll Cardiol. 1989 Apr;13(5):998-1005. doi: 10.1016/0735-1097(89)90250-7.
• Background Knatterud GL. Thrombolysis in myocardial infarction (TIMI) randomized studies versus TIMI open label studies. Control Clin Trials. 1989 Dec;10(4 Suppl):245S-256S. doi: 10.1016/0197-2456(89)90063-9.
• Background Chaitman BR, Thompson B, Wittry MD, Stump D, Hamilton WP, Hillis LD, Dwyer JG, Solomon RE, Knatterud GL. The use of tissue-type plasminogen activator for acute myocardial infarction in the elderly: results from thrombolysis in myocardial infarction Phase I, open label studies and the Thrombolysis in Myocardial Infarction Phase II pilot study. The TIMI Investigators. J Am Coll Cardiol. 1989 Nov 1;14(5):1159-65. doi: 10.1016/0735-1097(89)90410-5.
• Background TIMI Study Group. Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) phase II trial. N Engl J Med. 1989 Mar 9;320(10):618-27. doi: 10.1056/NEJM198903093201002.
• Background Chaitman BR, Thompson BW, Kern MJ, Vandormael MG, Cohen MB, Ruocco NA, Solomon RE, Braunwald E. Tissue plasminogen activator followed by percutaneous transluminal coronary angioplasty: one-year TIMI phase II pilot results. TIMI Investigators. Am Heart J. 1990 Feb;119(2 Pt 1):213-23. doi: 10.1016/s0002-8703(05)80007-9.
• Background Baim DS, Braunwald E, Feit F, Knatterud GL, Passamani ER, Robertson TL, Rogers WJ, Solomon RE, Williams DO. The Thrombolysis in Myocardial Infarction (TIMI) Trial phase II: additional information and perspectives. J Am Coll Cardiol. 1990 Apr;15(5):1188-92. doi: 10.1016/0735-1097(90)90263-o.
• Background Gertz SD, Kalan JM, Kragel AH, Roberts WC, Braunwald E. Cardiac morphologic findings in patients with acute myocardial infarction treated with recombinant tissue plasminogen activator. Am J Cardiol. 1990 Apr 15;65(15):953-61. doi: 10.1016/0002-9149(90)90996-e.
• Background Rogers WJ, Baim DS, Gore JM, Brown BG, Roberts R, Williams DO, Chesebro JH, Babb JD, Sheehan FH, Wackers FJ, et al. Comparison of immediate invasive, delayed invasive, and conservative strategies after tissue-type plasminogen activator. Results of the Thrombolysis in Myocardial Infarction (TIMI) Phase II-A trial. Circulation. 1990 May;81(5):1457-76. doi: 10.1161/01.cir.81.5.1457.
• Background Hillis LD, Forman S, Braunwald E. Risk stratification before thrombolytic therapy in patients with acute myocardial infarction. The Thrombolysis in Myocardial Infarction (TIMI) Phase II Co-Investigators. J Am Coll Cardiol. 1990 Aug;16(2):313-5. doi: 10.1016/0735-1097(90)90579-e.
• Background Gertz SD, Kragel AH, Kalan JM, Braunwald E, Roberts WC. Comparison of coronary and myocardial morphologic findings in patients with and without thrombolytic therapy during fatal first acute myocardial infarction. The TIMI Investigators. Am J Cardiol. 1990 Oct 15;66(12):904-9. doi: 10.1016/0002-9149(90)90923-o.
• Background Rogers WJ, Babb JD, Baim DS, Chesebro JH, Gore JM, Roberts R, Williams DO, Frederick M, Passamani ER, Braunwald E. Selective versus routine predischarge coronary arteriography after therapy with recombinant tissue-type plasminogen activator, heparin and aspirin for acute myocardial infarction. TIMI II Investigators. J Am Coll Cardiol. 1991 Apr;17(5):1007-16. doi: 10.1016/0735-1097(91)90823-r.
• Background Habib GB, Heibig J, Forman SA, Brown BG, Roberts R, Terrin ML, Bolli R. Influence of coronary collateral vessels on myocardial infarct size in humans. Results of phase I thrombolysis in myocardial infarction (TIMI) trial. The TIMI Investigators. Circulation. 1991 Mar;83(3):739-46. doi: 10.1161/01.cir.83.3.739.
• Background Roberts R, Rogers WJ, Mueller HS, Lambrew CT, Diver DJ, Smith HC, Willerson JT, Knatterud GL, Forman S, Passamani E, et al. Immediate versus deferred beta-blockade following thrombolytic therapy in patients with acute myocardial infarction. Results of the Thrombolysis in Myocardial Infarction (TIMI) II-B Study. Circulation. 1991 Feb;83(2):422-37. doi: 10.1161/01.cir.83.2.422.
• Background Bovill EG, Terrin ML, Stump DC, Berke AD, Frederick M, Collen D, Feit F, Gore JM, Hillis LD, Lambrew CT, et al. Hemorrhagic events during therapy with recombinant tissue-type plasminogen activator, heparin, and aspirin for acute myocardial infarction. Results of the Thrombolysis in Myocardial Infarction (TIMI), Phase II Trial. Ann Intern Med. 1991 Aug 15;115(4):256-65. doi: 10.7326/0003-4819-115-4-256.
• Background Gore JM, Sloan M, Price TR, Randall AM, Bovill E, Collen D, Forman S, Knatterud GL, Sopko G, Terrin ML. Intracerebral hemorrhage, cerebral infarction, and subdural hematoma after acute myocardial infarction and thrombolytic therapy in the Thrombolysis in Myocardial Infarction Study. Thrombolysis in Myocardial Infarction, Phase II, pilot and clinical trial. Circulation. 1991 Feb;83(2):448-59. doi: 10.1161/01.cir.83.2.448.
• Background Baim DS, Diver DJ, Feit F, Greenberg MA, Holmes DR, Weiner BH, Williams DO, Schweiger MJ, Brown BG, Frederick MM, et al. Coronary angioplasty performed within the thrombolysis in Myocardial Infarction II study. Circulation. 1992 Jan;85(1):93-105. doi: 10.1161/01.cir.85.1.93.
• Background Tofler GH, Muller JE, Stone PH, Forman S, Solomon RE, Knatterud GL, Braunwald E. Modifiers of timing and possible triggers of acute myocardial infarction in the Thrombolysis in Myocardial Infarction Phase II (TIMI II) Study Group. J Am Coll Cardiol. 1992 Nov 1;20(5):1049-55. doi: 10.1016/0735-1097(92)90356-r.
• Background Feit F, Mueller HS, Braunwald E, Ross R, Hodges M, Herman MV, Knatterud GL. Thrombolysis in Myocardial Infarction (TIMI) phase II trial: outcome comparison of a "conservative strategy" in community versus tertiary hospitals. The TIMI Research Group. J Am Coll Cardiol. 1990 Dec;16(7):1529-34. doi: 10.1016/0735-1097(90)90295-z.
• Background Kleiman NS, Terrin M, Mueller H, Chaitman B, Roberts R, Knatterud GL, Solomon R, McMahon RP, Braunwald E. Mechanisms of early death despite thrombolytic therapy: experience from the Thrombolysis in Myocardial Infarction Phase II (TIMI II) study. J Am Coll Cardiol. 1992 May;19(6):1129-35. doi: 10.1016/0735-1097(92)90313-c.
• Background Mueller HS, Cohen LS, Braunwald E, Forman S, Feit F, Ross A, Schweiger M, Cabin H, Davison R, Miller D, et al. Predictors of early morbidity and mortality after thrombolytic therapy of acute myocardial infarction. Analyses of patient subgroups in the Thrombolysis in Myocardial Infarction (TIMI) trial, phase II. Circulation. 1992 Apr;85(4):1254-64. doi: 10.1161/01.cir.85.4.1254.
• Background Williams DO, Braunwald E, Knatterud G, Babb J, Bresnahan J, Greenberg MA, Raizner A, Wasserman A, Robertson T, Ross R. One-year results of the Thrombolysis in Myocardial Infarction investigation (TIMI) Phase II Trial. Circulation. 1992 Feb;85(2):533-42. doi: 10.1161/01.cir.85.2.533.
• Background Zaret BL, Wackers FJ, Terrin ML, Ross R, Weiss M, Slater J, Morrison J, Bourge RC, Passamani E, Knatterud G, et al. Assessment of global and regional left ventricular performance at rest and during exercise after thrombolytic therapy for acute myocardial infarction: results of the Thrombolysis in Myocardial Infarction (TIMI) II Study. Am J Cardiol. 1992 Jan 1;69(1):1-9. doi: 10.1016/0002-9149(92)90667-n.
• Background Ruocco NA Jr, Bergelson BA, Jacobs AK, Frederick MM, Faxon DP, Ryan TJ. Invasive versus conservative strategy after thrombolytic therapy for acute myocardial infarction in patients with antecedent angina. A report from Thrombolysis in Myocardial Infarction Phase II (TIMI II). J Am Coll Cardiol. 1992 Dec;20(7):1445-51. doi: 10.1016/0735-1097(92)90435-p.
• Background Berger PB, Ruocco NA Jr, Ryan TJ, Frederick MM, Jacobs AK, Faxon DP. Incidence and prognostic implications of heart block complicating inferior myocardial infarction treated with thrombolytic therapy: results from TIMI II. J Am Coll Cardiol. 1992 Sep;20(3):533-40. doi: 10.1016/0735-1097(92)90004-7.
• Background Borzak S, Gheorghiade M. Early intravenous beta-blocker combined with thrombolytic therapy for acute myocardial infarction: the Thrombolysis in Myocardial Infarction (TIMI-2) Trial. Prog Cardiovasc Dis. 1993 Nov-Dec;36(3):261-6. doi: 10.1016/0033-0620(93)90018-9. No abstract available.
• Background Terrin ML, Williams DO, Kleiman NS, Willerson J, Mueller HS, Desvigne-Nickens P, Forman SA, Knatterud GL, Braunwald E. Two- and three-year results of the Thrombolysis in Myocardial Infarction (TIMI) Phase II clinical trial. J Am Coll Cardiol. 1993 Dec;22(7):1763-72. doi: 10.1016/0735-1097(93)90755-p.
• Background Chaitman BR, McMahon RP, Terrin M, Younis LT, Shaw LJ, Weiner DA, Frederick MM, Knatterud GL, Sopko G, Braunwald E. Impact of treatment strategy on predischarge exercise test in the Thrombolysis in Myocardial Infarction (TIMI) II Trial. Am J Cardiol. 1993 Jan 15;71(2):131-8. doi: 10.1016/0002-9149(93)90727-t.
• Background Taylor HA, Chaitman BR, Rogers WJ, Kern MJ, Terrin ML, Aguirre FV, Sopko G, McMahon R, Ross RN, Bovill EC. Race and prognosis after myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) phase II trial. Circulation. 1993 Oct;88(4 Pt 1):1484-94. doi: 10.1161/01.cir.88.4.1484.
• Background Berger PB, Ruocco NA, Ryan TJ, Frederick MM, Podrid PJ. Incidence and significance of ventricular tachycardia and fibrillation in the absence of hypotension or heart failure in acute myocardial infarction treated with recombinant tissue-type plasminogen activator: results from the Thrombolysis in Myocardial Infarction (TIMI) Phase II trial. J Am Coll Cardiol. 1993 Dec;22(7):1773-9. doi: 10.1016/0735-1097(93)90756-q.
• Background Berger PB, Ruocco NA Jr, Ryan TJ, Jacobs AK, Zaret BL, Wackers FJ, Frederick MM, Faxon DP. Frequency and significance of right ventricular dysfunction during inferior wall left ventricular myocardial infarction treated with thrombolytic therapy (results from the thrombolysis in myocardial infarction [TIMI] II trial). The TIMI Research Group. Am J Cardiol. 1993 May 15;71(13):1148-52. doi: 10.1016/0002-9149(93)90637-r.
• Background Lehmann KG, Francis CK, Sheehan FH, Dodge HT. Effect of thrombolysis on acute mitral regurgitation during evolving myocardial infarction. Experience from the Thrombolysis in Myocardial Infarction (TIMI) Trial. J Am Coll Cardiol. 1993 Sep;22(3):714-9. doi: 10.1016/0735-1097(93)90181-y.
• Background Schweiger MJ, McMahon RP, Terrin ML, Ruocco NA, Porway MN, Wiseman AH, Knatterud GL, Braunwald E. Comparison of patients with < 60% to > or = 60% diameter narrowing of the myocardial infarct-related artery after thrombolysis. The TIMI Investigators. Am J Cardiol. 1994 Jul 15;74(2):105-10. doi: 10.1016/0002-9149(94)90081-7.
• Background Becker RC, Terrin M, Ross R, Knatterud GL, Desvigne-Nickens P, Gore JM, Braunwald E. Comparison of clinical outcomes for women and men after acute myocardial infarction. The Thrombolysis in Myocardial Infarction Investigators. Ann Intern Med. 1994 Apr 15;120(8):638-45. doi: 10.7326/0003-4819-120-8-199404150-00003.
• Background Aguirre FV, McMahon RP, Mueller H, Kleiman NS, Kern MJ, Desvigne-Nickens P, Hamilton WP, Chaitman BR. Impact of age on clinical outcome and postlytic management strategies in patients treated with intravenous thrombolytic therapy. Results from the TIMI II Study. TIMI II Investigators. Circulation. 1994 Jul;90(1):78-86. doi: 10.1161/01.cir.90.1.78.
• Background Cox DA, Rogers WJ, Aguirre FV, Forman S, Solomon R, Zaret BL. Effect on outcome of the presence or absence of chest pain at initiation of recombinant tissue plasminogen activator therapy in acute myocardial infarction. The Thrombolysis in Myocardial Infarction Investigators. Am J Cardiol. 1994 Apr 15;73(11):729-36. doi: 10.1016/0002-9149(94)90872-9.
• Background Gersh BJ, Chesebro JH, Braunwald E, Lambrew C, Passamani E, Solomon RE, Ross AM, Ross R, Terrin ML, Knatterud GL. Coronary artery bypass graft surgery after thrombolytic therapy in the Thrombolysis in Myocardial Infarction Trial, Phase II (TIMI II). J Am Coll Cardiol. 1995 Feb;25(2):395-402. doi: 10.1016/0735-1097(94)00387-6.
• Background Zaret BL, Wackers FJ, Terrin ML, Forman SA, Williams DO, Knatterud GL, Braunwald E. Value of radionuclide rest and exercise left ventricular ejection fraction in assessing survival of patients after thrombolytic therapy for acute myocardial infarction: results of Thrombolysis in Myocardial Infarction (TIMI) phase II study. The TIMI Study Group. J Am Coll Cardiol. 1995 Jul;26(1):73-9. doi: 10.1016/0735-1097(95)00146-q.
• Background Hall C, Cannon CP, Forman S, Braunwald E. Prognostic value of N-terminal proatrial natriuretic factor plasma levels measured within the first 12 hours after myocardial infarction. Thrombolysis in Myocardial Infarction (TIMI) II Investigators. J Am Coll Cardiol. 1995 Nov 15;26(6):1452-6. doi: 10.1016/0735-1097(95)00342-8.
• Background Simon K, Szepvolgyi A. Early and 1-year clinical outcome of patients evolving non-Q-wave versus Q-wave myocardial infarction after thrombolysis: results from the TIMI II study. Circulation. 1995 Dec 15;92(12):3575-6. No abstract available.
• Background Mueller HS, Forman SA, Menegus MA, Cohen LS, Knatterud GL, Braunwald E. Prognostic significance of nonfatal reinfarction during 3-year follow-up: results of the Thrombolysis in Myocardial Infarction (TIMI) phase II clinical trial. The TIMI Investigators. J Am Coll Cardiol. 1995 Oct;26(4):900-7. doi: 10.1016/0735-1097(95)00270-1.
• Background Aguirre FV, Younis LT, Chaitman BR, Ross AM, McMahon RP, Kern MJ, Berger PB, Sopko G, Rogers WJ, Shaw L, et al. Early and 1-year clinical outcome of patients' evolving non-Q-wave versus Q-wave myocardial infarction after thrombolysis. Results from The TIMI II Study. Circulation. 1995 May 15;91(10):2541-8. doi: 10.1161/01.cir.91.10.2541.
• Background Sloan MA, Price TR, Petito CK, Randall AM, Solomon RE, Terrin ML, Gore J, Collen D, Kleiman N, Feit F, et al. Clinical features and pathogenesis of intracerebral hemorrhage after rt-PA and heparin therapy for acute myocardial infarction: the Thrombolysis in Myocardial Infarction (TIMI) II Pilot and Randomized Clinical Trial combined experience. Neurology. 1995 Apr;45(4):649-58. doi: 10.1212/wnl.45.4.649.
• Background Tracy RP, Kleiman NS, Thompson B, Cannon CP, Bovill EG, Brown RG, Collen D, Mahan E, Mann KG, Rogers WJ, Sopko G, Stump DC, Williams DO, Zaret BL. Relation of coagulation parameters to patency and recurrent ischemia in the Thrombolysis in Myocardial Infarction (TIMI) Phase II Trial. Am Heart J. 1998 Jan;135(1):29-37. doi: 10.1016/s0002-8703(98)70339-4.
• Background Braunwald E, Knatterud GL, Passamani E, Robertson TL, Solomon R. Update from the Thrombolysis in Myocardial Infarction Trial. J Am Coll Cardiol. 1987 Oct;10(4):970. doi: 10.1016/s0735-1097(87)80296-6. No abstract available.
• Background Robertson TL. Myocardial infarction: systemic thrombolysis in the U.S.A. Eur Heart J. 1987 Sep;8 Suppl F:67-71. doi: 10.1093/eurheartj/8.suppl_f.67. No abstract available.
• Background Lehmann KG, Francis CK, Dodge HT. Mitral regurgitation in early myocardial infarction. Incidence, clinical detection, and prognostic implications. TIMI Study Group. Ann Intern Med. 1992 Jul 1;117(1):10-7. doi: 10.7326/0003-4819-117-1-10.

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