Managing acute myocardial infarction: clinical implications of the TIM study

The prime objective of treatment in a patient with AMI is to minimize the s ize of the infarct, as this is one of the more critical factors in predicti ng outcome. The keystone of therapy is the recanalization of the infarct-re lated artery as rapidly, fully and durably as possible. This is generally a chieved by therapy with a combination of fibrinolytic, antithrombin and ant iplatelet agents, and the latest advances in these agents are reviewed here . The most frequently used antiplatelet agent has been aspirin, which is ef fective but associated with a number of disadvantages. The most significant of these is the risk of haemorrhage and cerebrovascula r events. Triflusal is a novel antiplatelet agent that inhibits platelet ac tivation by a number of mechanisms, in addition to those of aspirin. This p aper presents the preliminary results of the TIM (Triflusal In Myocardial i nfarction) study, which compared the efficacy and safety of triflusal compa red with aspirin in AMI patients, and discusses the clinical implications o f these findings.