Thrombolysis with tissue plasminogen activator in suspected acute myocardial infarction. The ASSET Study.

Abstract:

:Intravenous rtPA (total dose, 100 mg over 3 h) was compared with placebo in a prospective, randomized, double-blind trial in 5,011 patients with suspected AMI of less than 5 h duration. No ECG or enzymatic confirmation of the diagnosis was required for study entry. At 1 month 9.8% of patients given placebo had died compared with 7.2% of those who received rtPA (2.6% actual reduction, 26% relative reduction, with 95% confidence intervals of 11-39%). The majority of deaths occurred in patients who had an in-hospital diagnosis of MI (72% in both groups), with a 1-month infarct mortality of 13.1% in the placebo limb and 9.4% in the rtPA limb (relative reduction 28%, 95% CI, 14-41%). Approximately 18% of patients in both groups had a normal ECG on entry to the trial, and at 1 month the fatality was 1.6% in the rtPA group and 3.0% in the placebo group. Treatment with rtPA did not reduce the number of patients with normal ECGs from developing MI (28% rtPA vs 24% placebo). Treatment with rtPA was associated with significantly more bleeding episodes, the vast majority of which were clinically minor. The risk of all strokes in the rtPA group was similar to that in the placebo group (1.1% vs 1.0%). Treatment with rtPA was unaccompanied by either allergic or hypotensive episodes, and, among rtPA treated patients, there was no increase in clinically important ventricular dysrhythmias. Neither age nor time from onset of symptoms reduced the benefit from rtPA.

journal_name

Chest

journal_title

Chest

authors

Wilcox RG

subject

Has Abstract

pub_date

1989-05-01 00:00:00

pages

270S-275S

issue

5 Suppl

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)32980-4

journal_volume

95

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

相关文献

CHEST文献大全
  • Benefits of nocturnal nasal CPAP in patients with cystic fibrosis.

    abstract::Patients with cystic fibrosis (CF) often hypoventilate during sleep with marked falls in oxygen saturation (SaO2%). This occurs most commonly during REM sleep, when there is a reduction in rib cage excursion and a fall in end-expiratory lung volume (EELV). The aim of this study was to examine the effect of nocturnal n...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.6.1717

    authors: Regnis JA,Piper AJ,Henke KG,Parker S,Bye PT,Sullivan CE

    更新日期:1994-12-01 00:00:00

  • Smoking-Related Diffuse Cystic Lung Disease.

    abstract::Exposure to cigarette smoke can lead to a variety of parenchymal lung diseases, including diffuse cystic lung diseases (DCLDs). Lymphangioleiomyomatosis (LAM) is the prototypical DCLD and has a characteristic appearance on high-resolution CT (HRCT). We present a series of four patients with DCLD on HRCT who were refer...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2018.02.027

    authors: Gupta N,Colby TV,Meyer CA,McCormack FX,Wikenheiser-Brokamp KA

    更新日期:2018-08-01 00:00:00

  • Investigating the natural history of lung function: facts, pitfalls, and opportunities.

    abstract::COPD is currently defined as a progressive, preventable, and treatable disease that is characterized by an accelerated decline of lung function. However, contrary to other common chronic conditions like cardiovascular disease or cancer, there are no lifelong population-based studies describing the natural history of l...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.08-1750

    authors: Kohansal R,Soriano JB,Agusti A

    更新日期:2009-05-01 00:00:00

  • The relationship of sleepiness and blood pressure to respiratory variables in obstructive sleep apnea.

    abstract::As a follow-up to a previous assessment of complications of sleep-disturbed breathing in 265 patients, we have reevaluated measures of sleepiness and hypertension in patients with obstructive sleep apnea (OSA) (n = 518), central sleep apnea (n = 50), and subclinical sleep-disordered breathing (SDB) (n = 107). Both sub...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.108.4.966

    authors: Mendelson WB

    更新日期:1995-10-01 00:00:00

  • Comparative studies using a rigid thoracoscope and fiberoptic bronchoscope to treat spontaneous pneumothorax.

    abstract::Prior to 1978, the conventional treatment of pneumothorax generally consisted of conservative therapies such as rest, needle puncture, or thoracic cavity drainage; however, when conservative therapies were ineffective or relapse occurred therapeutic approach, 34 percent (11/32) of our patients required a thoracotomy. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.100.4.953

    authors: Tsukamoto T,Nakamura H,Satoh T,Yamada K,Nagasawa M

    更新日期:1991-10-01 00:00:00

  • The prevalence and predictors of respiratory-related work limitation and occupational disability in an international study.

    abstract:BACKGROUND:Work-related symptoms and disability due to respiratory disease are common and costly among working-age adults. To investigate this problem, we analyzed data on respiratory symptoms related to the workplace and occupational disability from the European Community Respiratory Health Survey (ECRHS). METHODS:Th...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:

    authors: Blanc PD,Burney P,Janson C,Torén K

    更新日期:2003-09-01 00:00:00

  • Amiodarone as a first-choice drug for restoring sinus rhythm in patients with atrial fibrillation: a randomized, controlled study.

    abstract:STUDY OBJECTIVES:To investigate the efficacy and safety of amiodarone administered as the drug of first choice in the conversion of atrial fibrillation, regardless of its duration. DESIGN:: Prospective, randomized, controlled clinical study. SETTING:: Tertiary cardiac referral center. PATIENTS:Two-hundred eight cons...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.117.6.1538

    authors: Vardas PE,Kochiadakis GE,Igoumenidis NE,Tsatsakis AM,Simantirakis EN,Chlouverakis GI

    更新日期:2000-06-01 00:00:00

  • Outcomes of Nurse Practitioner-Delivered Critical Care: A Prospective Cohort Study.

    abstract:BACKGROUND:Acute care nurse practitioners (ACNPs) are increasingly being employed in ICUs to offset physician shortages, but no data exist about outcomes of critically ill patients continuously cared for by ACNPs. METHODS:Prospective cohort study of all admissions to an adult medical ICU in an academic, tertiary-care ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2015.12.015

    authors: Landsperger JS,Semler MW,Wang L,Byrne DW,Wheeler AP

    更新日期:2016-05-01 00:00:00

  • Trends in the prevalence of obstructive and restrictive lung function among adults in the United States: findings from the National Health and Nutrition Examination surveys from 1988-1994 to 2007-2010.

    abstract:BACKGROUND:National spirometric surveillance data in the United States were last collected during 1988-1994. The objective of this study was to provide current estimates for obstructive and restrictive impairment of lung function and to examine changes since 1988-1994. METHODS:We used data from 14,360 participants age...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.12-1135

    authors: Ford ES,Mannino DM,Wheaton AG,Giles WH,Presley-Cantrell L,Croft JB

    更新日期:2013-05-01 00:00:00

  • Acute postbronchodilator changes in pulmonary function parameters in patients with chronic airways obstruction.

    abstract::Pulmonary function studies were performed before and after one-time administration of an inhaled bronchodilator to ascertain the relative diagnostic value of using FVC, FEF25-75%, static lung volumes, Raw, and/or sGaw measurements, in addition to the FEV1, to assess the reversibility of chronic airways obstruction in ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.93.3.541

    authors: Berger R,Smith D

    更新日期:1988-03-01 00:00:00

  • N-terminal pro-brain natriuretic peptide and renal insufficiency as predictors of mortality in pulmonary hypertension.

    abstract:BACKGROUND:N-terminal pro-brain natriuretic peptide (NT-proBNP) is a byproduct of the brain natriuretic peptide (BNP) that was shown to be of prognostic value in pulmonary hypertension (PH). The role of NT-proBNP in PH has to be determined, especially under the influence of renal impairment that might lead to an accumu...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.06-1758

    authors: Leuchte HH,El Nounou M,Tuerpe JC,Hartmann B,Baumgartner RA,Vogeser M,Muehling O,Behr J

    更新日期:2007-02-01 00:00:00

  • Heimlich valve treatment of Pneumocystis carinii-associated pneumothorax.

    abstract::Two patients were treated for AIDS-associated bilateral pneumothoraces which persisted despite prolonged chest tube drainage. Heimlich flutter valves were used to facilitate the outpatient management of these patients. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.100.1.281

    authors: Driver AG,Peden JG,Adams HG,Rumley RL

    更新日期:1991-07-01 00:00:00

  • Effects of long-term oxygen therapy on pulmonary hemodynamics in COPD patients: a 6-year prospective study.

    abstract:OBJECTIVE:To investigate effects of 6 years of domiciliary oxygen therapy on pulmonary hemodynamics in a large group of COPD patients. DESIGN:Prospective longitudinal study with serial measurements. SETTING:Research institute of pulmonary diseases. PATIENTS:Ninety-five patients (72 men, 23 women), mean age 58+/-9 ye...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.113.1.65

    authors: Zieliński J,Tobiasz M,Hawryłkiewicz I,Sliwiński P,Pałasiewicz G

    更新日期:1998-01-01 00:00:00

  • Global Initiative for Chronic Obstructive Lung Disease 2011 symptom/risk assessment in α1-antitrypsin deficiency.

    abstract:BACKGROUND:The new GOLD (Global Initiative for Chronic Obstructive Lung Disease) strategy recommends use of the COPD Assessment Test (CAT) or modified Medical Research Council (mMRC) scale to assess symptoms in COPD against "risk" as assessed by spirometry or exacerbation frequency. We aimed to determine the concordanc...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.13-0161

    authors: Pillai AP,Turner AM,Stockley RA

    更新日期:2013-10-01 00:00:00

  • Randomized clinical trial of endobronchial ultrasound needle biopsy with and without aspiration.

    abstract:BACKGROUND:Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (EBUS-TBNA) is performed with a dedicated 22- or 21-gauge needle while suction is applied. Fine-needle sampling without suction (capillary sampling) has been studied for endoscopic ultrasound and for biopsies at various body sites and ha...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1378/chest.11-0692

    authors: Casal RF,Staerkel GA,Ost D,Almeida FA,Uzbeck MH,Eapen GA,Jimenez CA,Nogueras-Gonzalez GM,Sarkiss M,Morice RC

    更新日期:2012-09-01 00:00:00

  • Perceptual and physiologic responses during treadmill and cycle exercise in patients with COPD.

    abstract:BACKGROUND:Although the cycle ergometer is the traditional mode for exercise testing in patients with respiratory disease, this preference over the treadmill does not consider perceptual responses. Our hypotheses were as follows: (1) the regression slope between breathlessness and oxygen consumption (Vo(2)) is greater ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.08-1258

    authors: Murray JA,Waterman LA,Ward J,Baird JC,Mahler DA

    更新日期:2009-02-01 00:00:00

  • Cancer genetics and cell and molecular biology. Is this the way forward?

    abstract::Lung cancer, the most prevalent cancer in the western world, is predominantly caused by smoking and thus perceived as a "self-inflicted" disease. Nevertheless, only 20% of smokers develop lung cancer. This review examines the concept of high-risk populations and screening. It looks at developments in the molecular epi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.109.5_supplement.125s

    authors: Smyth JF

    更新日期:1996-05-01 00:00:00

  • Dyphylline aerosol attenuates antigen-induced bronchoconstriction in experimental canine asthma.

    abstract::This study compared the bronchodilator effect in experimental canine asthma of dyphylline administered by aerosol and intravenous routes in doses producing equivalent concentrations of the drug in the plasma. Pulmonary resistance (RL) was calculated from simultaneous measurements of pressure and flow during fixed-volu...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.79.4.454

    authors: Hirshman CA,Lawyer C,Downes H,Farbood A,Rodgers R,Gerber N

    更新日期:1981-04-01 00:00:00

  • Biochemical response to treatment of bone hyperresorption in chronically critically ill patients.

    abstract:STUDY OBJECTIVE:The chronically critically ill (CCI) are a subgroup of critically ill patients who have survived an acute critical illness but remain profoundly debilitated and ventilator dependent. We have previously shown that CCI patients have a very high prevalence of bone hyperresorption. The objective of this pre...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.118.3.761

    authors: Nierman DM,Mechanick JI

    更新日期:2000-09-01 00:00:00

  • Reducing maintenance and repair costs in an interventional pulmonology program.

    abstract:BACKGROUND:In the current economic climate, hospitals and academic institutions demand that medical departments function in an efficient and cost-effective manner. Detailed business plans are necessary to build new clinical programs, and institutions have learned that new programs are associated with significant costs ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.127.4.1382

    authors: Lunn W,Garland R,Gryniuk L,Smith L,Feller-Kopman D,Ernst A

    更新日期:2005-04-01 00:00:00

  • Prolongation of ventricular depolarization. ECG manifestation of mexiletine toxicity.

    abstract::Mexiletine is a type 1B antiarrhythmic drug similar to lidocaine. Prolongation of ventricular depolarization has not been previously reported with the usual oral dosage of mexiletine. We describe a patient with renal failure and heart failure on low-dose oral therapy who developed mexiletine toxicity, which was manife...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.95.4.925

    authors: Nora MO,Chandrasekaran K,Hammill SC,Reeder GS

    更新日期:1989-04-01 00:00:00

  • Oral treprostinil for the treatment of pulmonary arterial hypertension in patients on background endothelin receptor antagonist and/or phosphodiesterase type 5 inhibitor therapy (the FREEDOM-C study): a randomized controlled trial.

    abstract:BACKGROUND:Infused and inhaled treprostinil are effective for treatment of pulmonary arterial hypertension (PAH), although their administration routes have limitations. This study assessed the efficacy and safety of bid oral sustained-release treprostinil in the treatment of PAH with a concomitant endothelin receptor a...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.11-2212

    authors: Tapson VF,Torres F,Kermeen F,Keogh AM,Allen RP,Frantz RP,Badesch DB,Frost AE,Shapiro SM,Laliberte K,Sigman J,Arneson C,Galiè N

    更新日期:2012-12-01 00:00:00

  • Use of an Ultrathin vs Thin Bronchoscope for Peripheral Pulmonary Lesions: A Randomized Trial.

    abstract:BACKGROUND:When evaluating peripheral pulmonary lesions, a 3.0-mm ultrathin bronchoscope (UTB) with a 1.7-mm working channel is advantageous regarding good access to the peripheral airway, whereas a 4.0-mm thin bronchoscope provides a larger 2.0-mm working channel, which allows the use of various instruments including ...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.chest.2019.06.038

    authors: Oki M,Saka H,Asano F,Kitagawa C,Kogure Y,Tsuzuku A,Ando M

    更新日期:2019-11-01 00:00:00

  • Figure-eight kinking of the aorta (pseudocoarctation) coexistent with coarctation.

    abstract::An asymptomatic young man presented with a cardiac murmur and hypertension only in the right arm. Angiograms showed kinking of the aortic arch with a figure-eight appearance consistent with pseudocoarctation. Before the kinked segment, also demonstrated were a stenotic lesion in the aortic arch proximal to the left ca...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.5.1239

    authors: Tsai LM,Fu M,Chang CH,Hung JS

    更新日期:1990-05-01 00:00:00

  • Dangerous curves. A perspective on exercise, lactate, and the anaerobic threshold.

    abstract::A number of general observations can be made from these recent studies. Lactate is a ubiquitous substance that is produced and removed from the body at all times, even at rest, both with and without the availability of oxygen. It is now recognized that lactate accumulates in the blood for several reasons, not just the...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.111.3.787

    authors: Myers J,Ashley E

    更新日期:1997-03-01 00:00:00

  • A 3-month-old infant with recurrent apparent life-threatening events in a car seat.

    abstract::A 3-month-old infant was brought to clinic for evaluation of recurrent apparent life-threatening events (ALTEs). Two ALTE episodes occurred while the infant was sleeping in a safety car seat. The first one occurred when he was 4 weeks old. His mother noticed that he was not breathing; he appeared limp with full body c...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.14-1595

    authors: DelRosso LM

    更新日期:2015-04-01 00:00:00

  • Pulmonary complications in lead miners.

    abstract::We carried out a study to assess the prevalence of respiratory disease in lead miners and to investigate the roles of silica and lead. We used a questionnaire for symptoms and examinations for signs of respiratory disease, chest roentgenograms, and spirometric study in 45 lead miners. Six underwent bronchoscopy and tr...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.96.1.18

    authors: Masjedi MR,Estineh N,Bahadori M,Alavi M,Sprince NL

    更新日期:1989-07-01 00:00:00

  • Immunosuppressive therapy in connective tissue diseases-associated pulmonary arterial hypertension.

    abstract:STUDY OBJECTIVE:Immune and inflammatory mechanisms could play a significant role in pulmonary arterial hypertension (PAH) genesis or progression, especially in patients with connective tissue diseases. Immunosuppressive therapy should be better evaluated in this setting. STUDY DESIGN:Monocentric retrospective study. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.130.1.182

    authors: Sanchez O,Sitbon O,Jaïs X,Simonneau G,Humbert M

    更新日期:2006-07-01 00:00:00

  • The effect of a computerized reminder system on the prevention of postoperative venous thromboembolism.

    abstract:STUDY OBJECTIVE:To measure the effect of an altered process of care, directed by a computerized reminder system, on rates of symptomatic postoperative venous thromboembolism. DESIGN:Comparisons of preintervention and postintervention measurements. SETTING:A university-affiliated community hospital in Utah. PATIENTS:...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.125.5.1635

    authors: Mosen D,Elliott CG,Egger MJ,Mundorff M,Hopkins J,Patterson R,Gardner RM

    更新日期:2004-05-01 00:00:00

  • Chronic tuberculous empyema with bronchopleural fistula resulting in treatment failure and progressive drug resistance.

    abstract::We treated five patients with a past history of tuberculous pleural infection that led to chronic, quiescent, loculated empyema. Reactivation of TB was associated with formation of BPF and recovery of drug-susceptible Mycobacterium tuberculosis from sputum. All patients had recurrence of positive sputum cultures that ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.100.1.124

    authors: Iseman MD,Madsen LA

    更新日期:1991-07-01 00:00:00