TACTICS-TIMI 18

OBJECTIVE: To compare invasive vs. conservative strategies among patients presenting with unstable angina and non-Q-wave myocardial infarction following treatment with the glycoprotein IIb/IIIa inhibitor tirofiban.

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  1. Invasive versus conservative strategies in unstable angina and non-Q-wave myocardial infarction following treatment with tirofiban: rationale and study design of the international TACTICS-TIMI 18 Trial. Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy. Thrombolysis In Myocardial Infarction. Cannon CP, Weintraub WS, Demopoulos LA, Robertson DH, Gormley GJ, Braunwald E. Am J Cardiol 1998;82:731-6.
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  2. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. Cannon CP, Weintraub WS, Demopoulos LA, et al. N Engl J Med 2001;344:1879-87.
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  3. Economics, health-related quality of life, and cost-effectiveness methods for the TACTICS (Treat Angina With Aggrastat [tirofiban] and Determine Cost of Therapy with Invasive or Conservative Strategy)-TIMI 18 trial. Weintraub WS, Culler SD, Kosinski A, et al. Am J Cardiol 1999;83:317-22.
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  4. Ability of minor elevations of troponins I and T to predict benefit from an early invasive strategy in patients with unstable angina and non-ST elevation myocardial infarction: results from a randomized trial. Morrow DA, Cannon CP, Rifai N, et al. JAMA 2001;286:2405-12.
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  5. TIMI risk score to predict 6-month mortality, recurrent cardiac events, and relative benefit of invasive vs. conservative strategy in patients with unstable angina: results from TACTICS-TIMI 18. Cannon CP, Weintraub WS, Demopoulos L, DiBattiste P, Robertson D, deLucca P, McCabe CH, Antman EM, Braunwald E, for the TACTICS-TIMI 18 Investigators. J Am Coll Cardiol 2001; 37 (Suppl A): 335A.
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  6. High-sensitivity C-reactive protein (hs-CRP) to predict 6 month mortality and relative benefit of invasive vs. conservative strategy in patients with unstable angina: Primary results of the TACTICS-TIMI 18 C-Reactive Protein substudy.Cannon CP, Weintraub WS, Demopoulos L, Vicari R, Bazzino O, Ali N, Robertson DH, De Lucca PT, DiBattiste P, Rifai N, Braunwald, for the TACTICS-TIMI18 Investigators. J Am Coll Cardiol. 2001; 37 (suppl. A): 315A.
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  7. Early initiation of tirofiban therapy before percutaneous intervention is associated with improved flow and tissue level perfusion: A TACTICS-TIMI 18 substudy. Gibson CM, Murphy SA, Weisberg S, Pai R, Kraimer N, Markovic R, De Feo T, Marble SJ, Robertson DH, Demopoulos LA, DiBattiste P, Cannon CP. Circulation. 2001;104 (Suppl II):II-548.
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  8. Early invasive strategy improves outcomes in acute coronary syndrome patients with prior CABG: results from TACTICS-TIMI 18. Kugelmass AD, Sadanandan S, Cannon CP, DiBattiste P, Demopoulos LA, Roberton, Braunwald E. Circulation. 2001;104 (Suppl II):II-548.
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  9. Length of stay for the treatment of acute coronary syndromes: international experience from the TACTICS-TIMI 18 trial.Mahoney EM, Jurkovitz C, Chu H, Alexander C, Demopoulos L, DiBattiste P, DeLucca PT, Cannon CP, Robertson DH, Weintraub W. Eur Heart J. 2001;22 (Abstr suppl):223.
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  10. Changes in Seattle angina questionnaire (SAQ) scores following treatment for acute coronary syndromes: a follow-up evaluation from the TACTICS-TIMI 18 trial. Mahoney EM, Jurkovitz C, Spertus J, Alexander C, Robertson DH, Demopoulos L, DiBattiste P, Cannon CP, Weintraub W, Chu H.Eur Heart J. 2001;22 (Abstr suppl):718.
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  11. Balloon size in percutaneous intervention is associated with abnormal myocardial perfusion: a TACTICS-TIMI 18 angiographic substudy. Murphy SA, Gibson CM, Cannon CP, Braunwald E. Eur Heart J. 2001;22 (Abstr suppl):285.
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  12. Extent of coronary artery disease and likelihood of revascularization in patients with UA/NSTEMI. Sabatine MS, McCabe C, Frey MJ, Robertson DH, Antman EM. Circulation. 2001;104 (Suppl II):II-548.
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  13. Outcomes of patients with spontaneous versus post PCI CK-MB elevation: data from TACTICS-TIMI 18 trial. Sadanandan S, Cannon CP, DiBattiste P, Demopoulos LA, Robertson DH, Kugelmass AD. Circulation. 2001;104 (Suppl II):II-697.
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  14. Cost-effectiveness analysis of tirofiban use in acute coronary syndromes.Watkins SP, De Lemos JA, Tokol G, Mahoney EM, Alexopoulos C, Goldsman D, Goldsman P, Yegin A, Bunt T, Cannon CP, Hamm CW, Weintraub WS. Circulation. 2001;104 (Suppl II):II-798.
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  15. Elevated C reactive protein (CRP) is associated with a higher risk of thrombotic occlusion and poorer flow following percutaneous coronary intervention in patients with acute coronary syndromes: A TACTICS-TIMI 18 angiographic substudy. Gibson CM, Morrow DA, Vicari R, Wong GC, Demopoulos LA, DiBattiste P, Murphy S, Cannon CP, Braunwald E. J Am Coll Cardiol. 2002;39 (Suppl A):304A.
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  16. Comparison of frequency and outcomes of investigator assessed recurrent MI versus clinical event committee (CEC) adjudicated recurrent MI in acute MI trials: A Timi 14 and Timi 9 substudy. Murphy S, Guigliano RP, Wong G, Cannon CP, Antman E, Gibson M. J Am Coll Cardiol. 2002;39:279A.
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  17. ST deviation and troponin provide independent prognostic and therapeutic information in UA/NSTEMI: Results from TACTICS-TIMI 18. Sabatine MS, Morrow D, DiBattiste P, Demopoulos L, McCabe C, Gibson CM, Cannon CP, Braunwald E. Circulation. 2002;106:2000A.
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  18. Heart-Type fatty acid binding protein is an independent predictor of death and major cardiac events in acute coronary syndromes. Sabatine MS, de Lemos J, Morrow D, Cannon CP, McCabe C, Braunwald E. Circulation. 2002;106:2259.
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  19. Cost and cost-effectiveness of an early invasive vs conservative strategy for the treatment of unstable angina and non-ST-segment elevation myocardial infarction. Mahoney EM, Jurkovitz CT, Chu H, et al. JAMA 2002;288:1851-8.
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  20. The prognostic value of serum myoglobin in patients with non-ST-segment elevation acute coronary syndromes. Results from the TIMI 11B and TACTICS-TIMI 18 studies. de Lemos JA, Morrow DA, Gibson CM, et al. J Am Coll Cardiol 2002;40:238-44.
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  21. Prospective analysis of creatine kinase muscle-brain fraction and comparison with troponin T to predict cardiac risk and benefit of an invasive strategy in patients with non-ST-elevation acute coronary syndromes. Kleiman NS, Lakkis N, Cannon CP, et al. J Am Coll Cardiol 2002;40:1044-50.
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  22. Multimarker approach to risk stratification in non-ST elevation acute coronary syndromes: simultaneous assessment of troponin I, C-reactive protein, and B-type natriuretic peptide. Sabatine MS, Morrow DA, de Lemos JA, et al. Circulation 2002;105:1760-3.
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  23. Elevations in troponin T and I are associated with abnormal tissue level perfusion: a TACTICS-TIMI 18 substudy. Treat Angina with Aggrastat and Determine Cost of Therapy with an Invasive or Conservative Strategy-Thrombolysis in Myocardial Infarction. Wong GC, Morrow DA, Murphy S, et al. Circulation 2002;106:202-7.
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  24. Benefit of an early invasive management strategy in women with acute coronary syndromes. Glaser R, Herrmann HC, Murphy SA, et al. JAMA 2002;288:3124-9.
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  25. Effects of renal insufficiency on early invasive management in patients with acute coronary syndromes (The TACTICS-TIMI 18 Trial). Januzzi JL, Cannon CP, DiBattiste PM, Murphy S, Weintraub W, Braunwald E. Am J Cardiol 2002;90:1246-9.
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  26. Outcome of Patients With Acute Coronary Syndrome Admitted to Hospitals With or Without Onsite Cardiac Catheterization Laboratory: A TACTICS-TIMI 18 Substudy. Lakkis N, Tsyboulev V, Gibson CM, et al. Crit Pathw Cardiol 2002;1:232-7.
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  27. Relationship between baseline white blood cell count and degree of coronary artery disease and mortality in patients with acute coronary syndromes: a TACTICS-TIMI 18 (Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy- Thrombolysis in Myocardial Infarction 18 trial)substudy. Sabatine MS, Morrow DA, Cannon CP, et al. J Am Coll Cardiol 2002;40:1761-8.
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  28. Efficacy and safety of multivessel percutaneous revascularization and tirofiban therapy in patients with acute coronary syndromes. Brener SJ, Murphy SA, Gibson CM, DiBattiste PM, Demopoulos LA, Cannon CP. Am J Cardiol 2002;90:631-3.
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  29. Evaluation of B-type natriuretic peptide for risk assessment in unstable angina/non-ST-elevation myocardial infarction: B-type natriuretic peptide and prognosis in TACTICS-TIMI 18. Morrow DA, de Lemos JA, Sabatine MS, et al. J Am Coll Cardiol 2003;41:1264-72.
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  30. Time for contrast material to traverse the epicardial artery and the myocardium in ST-segment elevation acute myocardial infarction versus unstable angina pectoris/non-ST-elevation acute myocardial infarction. Wong GC, Frisch D, Murphy SA, et al. Am J Cardiol 2003;91:1163-7.
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  31. Association of an activated clotting time < or =250 seconds with adverse event rates after percutaneous coronary intervention using tirofiban and heparin (a TACTICS-TIMI 18 substudy). Pinto DS, Lorenz DP, Murphy SA, et al. Am J Cardiol 2003;91:976-8, A4.
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  32. Major bleeding incidence after coronary artery bypass grafting in patients with unstable angina/non-st elevation myocardial infarction based on coronary artery bypass graft timing in TACTICS-TIMI-18. Bhadriraju S, Defranco AC, Barber K, Murphy S, Gibson CM, DiBattiste P, Cannon CP. J Am Coll Cardiol. 2003;41:374A.
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  33. A simple ECG method using high-risk infarct territory is superior to ECGs using summed ST elevation for assessing risk in ST elevation myocardial infarction.Wong GC, Murphy S, Morrow D, Giugliano R, Cannon CP, De Lemos J, Sabatine MS, Gibson CM. J Am Coll Cardiol. 2003;41:402A.
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  34. Association of B-type natriurectic peptide with angiographic findings in non-ST elevation acute coronary syndromes: A TACTICS-TIMI 18 substudy. Sadanandan S, Cannon CP, Murphy S, Chekuri K, Partin M, DiBattiste P, Morrow D, de Lemos J, McCabe C, Braunwald E, Gibson CM. Circulation. 2003;108:1759.
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  35. Association of multivessel disease, inflammatory markers and impaired tissue level perfusion in the setting of acute coronary syndromes: A TACTICS-TIMI 18 substudy. Jordan M, Dotani MI, Dumaine R, Wong G, Aroesty JM, Cannon CP, McCabe C, Braunwald E, Gibson CM. Circulation. 2003;108:2157.
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  36. Association of Major Bleeding with Adverse Clinical Outcomes and Length of Stay: A TACTICS TIMI 18 Substudy. Jordan M, Cohen DE, Wong GC, Cannon CP, Braunwald E, Gibson CM. J AmColl Cardiol 2003;42(6) 375A.
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  37. Impact of troponin status and coronary artery disease by angiography on outcome in acute coronary syndrome: A TACTICS TIMI-18 substudy. Pillai M, DiBattiste P, Murphy S, Morrow D, Cannon CP, Lakkis N. J Am Coll Cardiol. 2004;43:307A.
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  38. Underachievement of low-density lipoprotein cholesterol goal in patients on statins in clinical practice: Are we using low doses of statins too often? J Am Coll Cardiol. 2004;43:250A. Braganza AJM, Eminowicz G, Murphy S, DiBattiste P, Flaker GC, Cannon CP.
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  39. Differential expression of cardiac biomarkers by gender in patients with unstable angina/non-ST-elevation myocardial infarction: a TACTICS-TIMI 18 (Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy-Thrombolysis In Myocardial Infarction 18) substudy.Wiviott SD, Cannon CP, Morrow DA, et al. Circulation 2004;109:580-6.
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  40. Implications of upstream glycoprotein IIb/IIIa inhibition and coronary artery stenting in the invasive management of unstable angina/non-ST-elevation myocardial infarction: a comparison of the Thrombolysis In Myocardial Infarction (TIMI) IIIB trial and the Treat angina with Aggrastat and determine Cost of Therapy with Invasive or Conservative Strategy (TACTICS)-TIMI 18 trial.Sabatine MS, Morrow DA, Giugliano RP, et al. Circulation 2004;109:874-80.
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  41. The impact of management strategy on clinical outcome for elderly patients with non-ST elevation acute coronary syndromes. Bach RG, Cannon CP, Weintraub WS, DiBattiste PM, Demopoulos LA, Anderson HV, DeLucca PT, Mahoney EM, Murphy SA, Braunwald E. Ann Intern Med 2004;141-186-95.
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  42. Validated risk score predicts the development of congestive heart failure after presentation with unstable angina or non-ST-elevation myocardial infarction: results from OPUS-TIMI 16 and TACTICS-TIMI 18. Wylie JV, Murphy SA, Morrow DA, de Lemos JA, Antman EM, Cannon CP. Am Heart J 2004;148:173-80.
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  43. Timing of angiography and revascularization in acute coronary syndromes: an analysis of the TACTICS-TIMI-18 trial. McCullough PA, Gibson CM, Dibattiste PM, et al. J Interv Cardiol 2004;17:81-6.
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  44. Greater Benefit of Early Invasive Strategy for Unstable Angina and Non-ST Elevation Myocardial Infarction in United States Compared With Non-United States Patients: A TACTICS-TIMI 18 Substudy. Herrmann HC, Murphy SA, Dibattiste PM, et al. Crit Pathw Cardiol 2004;3:95-100.
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  45. Association between duration of tirofiban therapy before percutaneous intervention and tissue level perfusion (a TACTICS-TIMI 18 substudy). Gibson CM, Singh KP, Murphy SA, et al. Am J Cardiol 2004;94:492-4.
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  46. Prognostic implications of elevated troponin in patients with suspected acute coronary syndrome but no critical epicardial coronary disease: a TACTICS-TIMI-18 substudy. Dokainish H, Pillai M, Murphy SA, et al. J Am Coll Cardiol 2005;45:19-24.
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  47. Influence of race on death and ischemic complications in patients with non-ST-elevation acute coronary syndromes despite modern, protocol-guided treatment. Sabatine MS, Blake GJ, Drazner MH, et al. Circulation 2005;111:1217-24.
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  48. Comparison of the effects of pravastatin and atorvastatin on fracture incidence in the PROVE IT-TIMI 22 trial--secondary analysis of a randomized controlled trial.Reid IR, Tonkin A, Cannon CP. Bone 2005;37:190-1.
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  49. Peripheral arterial disease, acute coronary syndromes, and early invasive management: the TACTICS TIMI 18 trial. Januzzi JL, Jr., Buros J, Cannon CP. Clin Cardiol 2005;28:238-42.
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  50. C-reactive protein and cardiovascular outcomes in smokers versus nonsmokers in non-ST-elevation acute coronary syndrome (from the TACTICS-TIMI 18 trial).Moghbeli N, Kirtane AJ, Ray KK, et al. Am J Cardiol 2005;96:635-8.
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  51. Peripheral arterial disease, acute coronary syndromes, and early invasive management: the TACTICS TIMI 18 trial. Januzzi JL, Jr., Buros J, Cannon CP. Clin Cardiol 2005;28:238-42.
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  52. C-reactive protein and cardiovascular outcomes in smokers versus nonsmokers in non-ST-elevation acute coronary syndrome (from the TACTICS-TIMI 18 trial).Moghbeli N, Kirtane AJ, Ray KK, et al. Am J Cardiol 2005;96:635-8.
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  53. Combination of quantitative ST deviation and troponin elevation provides independent prognostic and therapeutic information in unstable angina and non-ST-elevation myocardial infarction. Sabatine MS, Morrow DA, McCabe CH, Antman EM, Gibson CM, Cannon CP. Am Heart J 2006;151:25-31.
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  54. Concurrent evaluation of novel cardiac biomarkers in acute coronary syndrome: myeloperoxidase and soluble CD40 ligand and the risk of recurrent ischaemic events in TACTICS-TIMI 18. Morrow DA, Sabatine MS, Brennan ML, et al. Eur Heart J 2008;29:1096-102.
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  55. Early Invasive Strategy Improves Outcomes in Patients With Acute Coronary Syndrome With Previous Coronary Artery Bypass Graft Surgery: A Report From TACTICS-TIMI 18. Kugelmass AD, Sadanandan S, Lakkis N, et al. Crit Pathw Cardiol 2006;5:167-72.
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  56. Concurrent evaluation of novel cardiac biomarkers in acute coronary syndrome: myeloperoxidase and soluble CD40 ligand and the risk of recurrent ischaemic events in TACTICS-TIMI 18. Morrow DA, Sabatine MS, Brennan ML, et al. Eur Heart J 2008;29:1096-102.
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