(Circulation. 1999;100:570-575.)
© 1999 American Heart Association, Inc.
Cardiovascular News |
Meeting Highlights
Highlights of the 48th Scientific Sessions of the American College of Cardiology
From Texas Heart Institute, St. Luke's Episcopal Hospital, Baylor College of Medicine, The University of Texas Health Science Center at Houston, Houston, Tex.
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The following trials were presented at the 48th Scientific Sessions of the American College of Cardiology, March 7–10, 1999, in New Orleans, La.
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Unstable Angina |
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The Trial: FRISC II
Presenters: Lars Wallentin and Bo Lagerqvist, Cardiothoracic Centre, University Hospital, Uppsala, Sweden.
The study: A randomized, placebo-controlled trial of low-molecular-weight heparin (dalteparin) in conjunction with either early revascularization or conservative medical therapy in 2457 patients with unstable angina or non–Q-wave myocardial infarction (MI). On admission, all patients received dalteparin (120 IU/kg every 12 hours) for the acute treatment phase (5 to 7 days) and were randomized to receive either invasive (n=1222; routine angiography and intervention, if indicated, within 2 to 7 days) or conservative (n=1235; angiography and intervention only if driven by refractory clinical symptoms) treatment. After the acute treatment phase, patients were further randomized to treatment with dalteparin (5000 or 7500 IU BID) or placebo in a prolonged (90 day), double-blind treatment phase. The primary endpoint of the study was a clinical outcome of death or MI (defined both conservatively [2/3 of pain, ECG changes, and enzyme elevation] or using enzymatic markers); initial 3-month follow-up data were presented.
The results: A total of 98% (95% within 6 days) of the
invasive treatment group underwent angiography, compared with 48%
(14% within 6 days) of the conservative treatment group.
Revascularization was performed in 78% of patients
in the invasive treatment group (44% had percutaneous coronary
intervention [PCI] and 34% had coronary artery bypass
grafting [CABG]) and 38% of patients in the conservative treatment
group (18% had PCI and
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