Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort Study.

IF 2.3 4区医学 Q2 HEMATOLOGY

Clinical and Applied Thrombosis/Hemostasis Pub Date : 2025-01-01 DOI:10.1177/10760296251316876

Adham Mohamed, Sara Mahmoud, Amr M Fahmi, Ahmed Mahfouz, Tayseer Kanaan, Jihad Jaber, Mansour Alkhawi, Saleh Alkhalaf, Hassan Kodimi, Ahmed Shaaban, Omar Alshibli, Awad Almasalmeh, Salaheddin Arafa, Salah Elbdri, Suhail Falah, Fayez Altrad, Ezeldin Soaly, Rasha Elenany, Sumaya Alyafei, Abdul Rahman Arabi

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引用次数: 0

Abstract

Purpose: The aim of this study is to compare the efficacy and safety of both agents in patients with acute STEMI.

Methods: This was a multicenter retrospective observational study comparing tenecteplase and reteplase in patients with acute STEMI. The primary outcome was the incidence of failed thrombolysis. Secondary outcomes included the incidence of major bleeding, cardiogenic shock, re-infarction and mortality.

Results: A total of 282 patients were included, 229 and 53 received tenecteplase and reteplase, respectively. The incidence of failed thrombolysis was 33.2% in the tenecteplase group compared to 20.8% in the reteplase group (adjusted odds ratio 0.53, 95% confidence interval 0.25-1.1; p = 0.089). The incidence of major bleeding was 0.9% in the tenecteplase group and 5.7% in the reteplase group (p = 0.017). There was no significant difference in mortality or other secondary outcomes.

Conclusion: There was no difference in the primary outcome of failed thrombolysis between tenecteplase and reteplase; however, major bleeding events were significantly higher in the reteplase group. Randomized controlled trials are needed to confirm our findings.

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目的：本研究旨在比较两种药物对急性 STEMI 患者的疗效和安全性：这是一项多中心回顾性观察研究，比较了替奈普酶和雷替普酶对急性 STEMI 患者的疗效。主要结果是溶栓失败的发生率。次要结果包括大出血、心源性休克、再梗死和死亡率：共纳入282例患者，其中229例和53例分别接受了替奈普酶和再普酶治疗。替奈替普酶组溶栓失败的发生率为33.2%，而再普酶组为20.8%（调整后的几率比为0.53，95%置信区间为0.25-1.1；P = 0.089）。特奈普酶组大出血发生率为0.9%，而再普酶组为5.7%（P = 0.017）。死亡率或其他次要结果无明显差异：结论：替奈替普酶和再替普酶在溶栓失败这一主要结果上没有差异；但是，再替普酶组的大出血事件明显高于替奈替普酶组。需要进行随机对照试验来证实我们的研究结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Applied Thrombosis/Hemostasis 医学-外周血管病

CiteScore

4.40

自引率

3.40%

发文量

150

审稿时长

2 months

期刊介绍： CATH is a peer-reviewed bi-monthly journal that addresses the practical clinical and laboratory issues involved in managing bleeding and clotting disorders, especially those related to thrombosis, hemostasis, and vascular disorders. CATH covers clinical trials, studies on etiology, pathophysiology, diagnosis and treatment of thrombohemorrhagic disorders.