{'fraction_non_alphanumeric': 0.05707297187117815, 'fraction_numerical': 0.030574806359559722, 'mean_word_length': 4.628440366972477, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Mycotic aneurysm and arteriocaval fistula

Objective: TETAMI was undertaken to demonstrate that the low-molecular-weight heparin (LMWH) enoxaparin (Lovenox, Aventis Pharmaceuticals, Bridgewater, N.J., U.S.A.), given for 2–8 days to nonreperfused patients with ST-segment-elevation MI (STEMI) significantly reduces the 30-day sum of death, reinfarction, and recurrent angina compared with unfractionated heparin (UFH). Patient population: TETAMI included 1,224 patients at 91 centers in 14 countries worldwide. Median age was ~64 years (~72% male). ST-segment-elevation was found in ~86%, and Q waves in ~68%. Trial design: Patients were randomized to antithrombotic treatment for 2 to 8 days. All patients received either the LMWH enoxaparin 30 mg IV plus 1 mg/kg subcutaneously bid or UFH 70 U/kg IV plus aPTT-adjusted 15 U/kg/h infusion. In addition, all patients received either the GP IIb/IIIa inhibitor tirofiban (Aggrastat, Merck & Co., Whitehouse Station, N.J., U.S.A.) 100 mg/kg IV plus 0.1 μg/kg/min infusion or placebo. All patients received aspirin. The primary endpoint was the combined incidence of death, recurrent MI, or recurrent angina at 30 days, with enoxaparin versus UFH as the primary comparison. Results: The primary 30-day endpoint occurred in 15.7% of patients in the enoxaparin group, in 16.1% of the enoxaparin + tirofiban group, in 17.3% of the UFH group, and in 17.2% of the UFH + tirofiban group. Differences for the composite endpoint, and between its components, were not significant. For patients without left ventricular dysfunction (Killip class I), there was a larger difference in the primary endpoint favoring enoxaparin (13.5 vs. 16.5% with UFH), but the difference was still nonsignificant. Rates for the primary endpoint for those receiving tirofiban and placebo were 16.6 and 16.4%, respectively. Major hemorrhage rates at 30 days were 1.5% for enoxaparin, 1.3% for UFH, 1.8% for tirofiban, and 1% for placebo. Conclusions: The primary study objective was not met in this challenging study population with heterogeneous risk. Enoxaparin has an efficacy and safety profile similar to that of UFH, and may be an alternative to UFH in nonreperfused STEMI patients. Enoxaparin may be more promising in the lower-risk patients. Tirofiban combined with enoxaparin or UFH did not show a benefit in this population. Comment (Marc Cohen, M.D.): Results are confounded by pre-use of UFH in 28% of all patients treated. 45