On-Time 2 stands for: Ongoing Tirofiban In Myocardial Evaluation

The trial investigated the effect of early up-front treatment with a high bolus dosage of tirofiban compared with no treatment in open label phase or placebo in double blind phase in addition to background treatment, on the extent of residual ST segment deviation 1 hour after Primary Coronary Angioplasty for acute myocardial infarction.

In total 414 patients were enrolled in the open label phase and 1398 patients in the double blind phase. The trial was conducted in Germany, Belgium and The Netherlands.

On-TIME 2 shows that routine prehospital initiation of high-bolus dose tirofiban improved ST-segment resolution and clinical outcome after PCI, emphasizes that further platelet aggregation inhibition besides high-dose clopidogrel is mandated in patients with STEMI undergoing PCI.

Trial investigators:

Open label phase
Isala klinieken, Zwolle (NL) - A.W.J. van ’t Hof MD, PhD
St. Antonius Ziekenhuis, Nieuwegein (NL) - J.M. ten Berg MD, PhD

Double blind phase
Isala klinieken, Zwolle (NL) - A.W.J. van ’t Hof MD, PhD
St. Antonius Ziekenhuis, Nieuwegein (NL) - J.M. ten Berg MD, PhD
Medisch Spectrum Twente, Enschede (NL) - K.G. v Houwelingen MD
UMC, Utrecht (NL) - P.R. Stella, MD, PhD
Kerckhoff-klinik GmbH, Bad Nauheim (DE) - C. Hamm, MD, PhD
Universitätsklinikum, Heidelberg (DE) - G. Giannitsis MD, PhD
St. Johannes Hospital, Dortmund (DE) - Heuer MD, PhD
Klinikum Coburg GmbH (DE) - J. Brachmann MD, PhD
Klinikum Lüdenscheid (DE) - Lemke MD, PhD
Segeberger Kliniken GmbH (DE) - G. Richardt MD PhD
Philipps Universität, Marburg (DE) - Maisch MD, PhD
Allgemeines Krankenhaus Celle (DE) - W. Terres MD, PhD
Aniversitätsklinik Giessen (DE) - H. Tillmanns MD, PhD
Ilmtalklinik, Pfaffenhofen (DE) - Ch. Fischke MD, PhD
Med. Hochschule, Hannover (DE) - Schieffer, MD, PhD
Uniklinik, Mannheim (DE) - T. Süselbeck MD, PhD
Universitätsklinikum Lübeck (DE) - H. Schunkert MD, PhD
Stätisches Klinikum Lüneburg (DE) - W. Kupper MD, PhD
Universitätsklinikum Rostock (DE) - C. Nienaber MD, PhD
Kreiskrankenhaus Bergstrasse Heppenheim (DE) - W. Auch-Schwelk MD, PhD
Asklepios Klinik St. Georg, Hamburg (DE) - K.H. Kuck MD, PhD
Klinikum Darmstadt (DE) - G. Werner MD, PhD
Evangelisches Krankenhaus gGmbH Holzminden (DE) - Ch. Beythien MD, PhD
A.Z. Sint-Jan AV Brugge (B) - P. Coussement MD, PhD

Clinical trial information:


Main Publications:

  • Arnoud W J van‘t Hof, Jurriën ten Berg, Ton Heestermans et al. on behalf of the Ongoing Tirofiban In Myocardial infarction Evaluation (On-TIME) 2 study group.  Prehospital initiation of tirofiban in patients with ST-elevation myocardial infarction undergoing primary angioplasty (On-TIME2): a multicentre, double-blind, randomised controlled trial. Lancet. 2008;372:537-46.
  • Effect of early, pre-hospital initiation of high bolus dose tirofiban in patients with ST-segment elevation myocardial infarction on short- and long-term clinical outcome. Ten Berg JM, van 't Hof AW, Dill T et al. J Am Coll Cardiol. 2010;55:2446-55.