Comparison of rapidity of coronary recanalization in men with tenecteplase versus alteplase in acute myocardial infarction.
To determine whether tenecteplase (TNK-t-PA), a bioengineered variant of tissue-type plasminogen activator (t-PA) designed to accelerate thrombolysis, exhibits favorable properties compared with those of alteplase, 266 men were studied </=6 hours after the onset of symptoms and signs of acute myocardial infarction. The primary end point was the rapidity of recanalization as judged from analysis of serial changes in the concentrations in blood of isoforms of creatine kinase-MM in serially obtained blood samples. Additional end points included enzymatically estimated infarct size and mortality. Patients were treated quite promptly after the onset of symptoms. The interval from the onset of chest pain to recanalization seen with TNK-t-PA was 208 +/- 10 (SE) minutes compared with 237 +/- 9 minutes seen with alteplase (p = 0.04). Thirty-day mortality was low with the use of the 2 agents (2%). TNK-t-PA appears to induce recanalization more rapidly than alteplase, and thrombolysis initiated early after the onset of symptoms is associated with remarkably low mortality.
Binbrek
Azan S
AS
Rashid Hospital, Dubai, United Arab Emirates.
Rao
Nayan S
NS
Neimane
Dagnija
D
Hatou
Eman
E
Abdulali
Sultan
S
Sobel
Burton E
BE
D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood; D052283:Creatine Kinase, MM Form; D004305:Dose-Response Relationship, Drug; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D000077785:Tenecteplase; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D007527:Isoenzymes; D006493:Heparin; D003402:Creatine Kinase; D052283:Creatine Kinase, MM Form; D010959:Tissue Plasminogen Activator; D001241:Aspirin; D000077785:Tenecteplase