Safety and Tolerability of a Modified TIMI-14 Protocol in AMI Patients: A Pilot Study

hrombolytic treatment has demonstrated an importantreduction of mortality (30 to 6.3 %) in patients thrombo-lysed within 6 hours from onset of symptoms [1]. The AMIsinvolving a large area of myocardium show a high mortality(20–25 %) [2] and these patients appear to receive a greaterbenefit by an aggressive treatment (primary or rescue PTCA)when thrombolysis is unsuccessful [3, 4]. Unfortunately, aquarter of patients show failure to lyse occlusive thrombi,reocclusion occurs in 10 % of patients, and incomplete reper-fusion is present in 30 % [5, 6]. Because interventional labo-ratories are not available in all hospitals, and often, when theyare available, they are not open 24 hours a day, other attemptsto obtain reperfusion were used (rescue thrombolysis) withincreased incidence of major bleeding [7]. The recent TIMI-14 trial showed that the combination of reduced-dose throm-bolysis and abciximab determined an increase of patency at90 min [8]. The aim of the study was to compare a TIMI-14modified protocol versus TIMI-14 protocol in AMI patientsand to verify safety and tolerability of the modified protocol.