The Clinical Trial of Reviparin and Metabolic Modulation in Acute Myocardial Infarction Treatment Evaluation
To evaluate the effects of reviparin, a low-molecular-weight heparin, on mortality, reinfarction, and strokes in patients with acute myocardial infarction presenting with ST-segment elevation. The trial found that in patients with acute ST-segment elevation reviparin reduces mortality and reinfarction, without a substantive increase in overall stroke rates. There was a small absolute excess of life-threatening bleeding but the benefits outweigh the risks.
Randomized, controlled trial with partial 2×2 factorial design.
The first coprimary outcome was a composite of death, reinfarction, or stroke at 7 days, while the second coprimary outcome was the first outcome with the addition of ischemia with electrocardiogram changes, also at 7 days. Secondary outcomes included the components of these coprimary outcomes, any ischemia at 7 days, and 30-day outcomes, which included the same composites. The major safety outcme was major bleeding. All efficacy and safety outcomes were adjudicated.
Salim Yusuf, Shamir Mehta