Skip to contents
In This Issue:
For the past 24 years, the BWH-based TIMI trials have been revolutionizing the care of cardiac patients. Since TIMI began in 1984, mortality from heart attacks has dropped almost in half, and the TIMI Study Group isn’t slowing down.
Just last November, data from TRITON-TIMI 38 showed that the new anti-platelet drug prasugrel is superior to clopidogrel in more rapidly and consistently preventing serious events among patients with acute coronary syndromes undergoing coronary stent procedures.
“The results of this trial are dramatic and good news for patients,” said Elliott Antman, MD, director of the Coronary Care Unit at BWH and principal investigator of TRITON-TIMI 38.
The researchers also found that prasugrel produced a 52 percent reduction in stent thrombosis, a serious complication following stenting, and an overall 34 percent reduction in the need for urgent re-treatment of the original heart artery in which the stent was placed. Additionally, the study showed a 24 percent reduction in heart attacks among those taking prasugrel compared to clopidogrel.
The TIMI Study Group is now actively recruiting participants for TRA-2P TIMI 50. This study, led by David Morrow, MD, is a 19,500-patient trial for a new class of anti-platelet heart medication for patients who have had a heart attack, stroke or existing peripheral arterial disease. The BWH-led trial will evaluate the reduction in risk of experiencing a serious cardiovascular event among participants taking the thrombin receptor antagonist (TRA) compared to patients who receive placebo plus standard of care.
“Patients who have had a heart attack or stroke are at high risk for having another potentially life-threatening cardiovascular event,” Morrow said. “It is an important goal of treatment to reduce that risk without the high incidence of bleeding that frequently accompanies currently available therapies.”
TIMI, which stands for Thrombolysis in Myocardial Infarction, began as a single clinical trial of a new clot-busting drug for heart attack patients in 1984 when it was established by Eugene Braunwald, MD, the chairman, and Carolyn McCabe, the director. Since then, TIMI has grown into an enormous international endeavor with trials taking place in more than 50 countries and 1,500 hospitals.
For each trial, the group spends years conceptualizing, organizing and gathering data. Then it works with medical organizations to update guidelines for use by practicing physicians. “Our goal is not to write papers,” said Braunwald. “It’s to improve patient care.”
The trials have provided data on virtually every nonsurgical treatment of coronary artery disease and have branched out to include procedures like angioplasty.
When the Shapiro Cardiovascular Center opens this spring, it will facilitate clinical research and bring clinicians and researchers together through patient care-related integration. “The TIMI group members are active clinicians in the Cardiovascular Division, and this allows them the opportunity to apply immediately those lessons learned through their worldwide trials and to be constantly aware of new clinical problems that need to be addressed,” said Kenneth Baughman, MD, director of the Advanced Heart Disease Section at BWH.