Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort Study
Coronary artery disease is one of the leading causes of death globally. Despite the increased number of percutaneous coronary intervention (PCI) capable facilities, fibrinolytic therapy is still being utilized especially in rural areas. No studies have directly compared tenecteplase and reteplase in...
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SAGE Publishing
2025-02-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296251316876 |
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| author | Adham Mohamed PharmD Sara Mahmoud PharmD Amr M. Fahmi PhD Ahmed Mahfouz MSc Tayseer Kanaan MD Jihad Jaber MD Mansour Alkhawi MD Saleh Alkhalaf MD Hassan Kodimi MD Ahmed Shaaban MD Omar Alshibli MD Awad Almasalmeh MD Salaheddin Arafa MD Salah Elbdri MD Suhail Falah MD Fayez Altrad MD Ezeldin Soaly MD Rasha Elenany PharmD Sumaya Alyafei PharmD Abdul Rahman Arabi MD |
| author_facet | Adham Mohamed PharmD Sara Mahmoud PharmD Amr M. Fahmi PhD Ahmed Mahfouz MSc Tayseer Kanaan MD Jihad Jaber MD Mansour Alkhawi MD Saleh Alkhalaf MD Hassan Kodimi MD Ahmed Shaaban MD Omar Alshibli MD Awad Almasalmeh MD Salaheddin Arafa MD Salah Elbdri MD Suhail Falah MD Fayez Altrad MD Ezeldin Soaly MD Rasha Elenany PharmD Sumaya Alyafei PharmD Abdul Rahman Arabi MD |
| author_sort | Adham Mohamed PharmD |
| collection | DOAJ |
| description | Coronary artery disease is one of the leading causes of death globally. Despite the increased number of percutaneous coronary intervention (PCI) capable facilities, fibrinolytic therapy is still being utilized especially in rural areas. No studies have directly compared tenecteplase and reteplase in patients with ST-elevation myocardial infarction (STEMI). 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. |
| format | Article |
| id | doaj-art-0ffc590694564823a057f2389133bc7d |
| institution | Kabale University |
| issn | 1938-2723 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj-art-0ffc590694564823a057f2389133bc7d2025-02-05T08:03:54ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232025-02-013110.1177/10760296251316876Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort StudyAdham Mohamed PharmD0Sara Mahmoud PharmD1Amr M. Fahmi PhD2Ahmed Mahfouz MSc3Tayseer Kanaan MD4Jihad Jaber MD5Mansour Alkhawi MD6Saleh Alkhalaf MD7Hassan Kodimi MD8Ahmed Shaaban MD9Omar Alshibli MD10Awad Almasalmeh MD11Salaheddin Arafa MD12Salah Elbdri MD13Suhail Falah MD14Fayez Altrad MD15Ezeldin Soaly MD16Rasha Elenany PharmD17Sumaya Alyafei PharmD18Abdul Rahman Arabi MD19 Department of Pharmacy, Saint Luke's Hospital of Kansas City, Kansas City, MO, USA Department of Pharmacy Practice, University of Pacific Thomas J. Long School of Pharmacy, Stockton, CA, USA Department of Pharmacy, , Doha, Qatar Department of Pharmacy, , Doha, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Cardiology, Al-Wakra Hospital, Hamad Medical Corporation, Al-Wakra, Qatar Department of Pharmacy, , Doha, Qatar Department of Pharmacy, , Doha, Qatar Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, QatarCoronary artery disease is one of the leading causes of death globally. Despite the increased number of percutaneous coronary intervention (PCI) capable facilities, fibrinolytic therapy is still being utilized especially in rural areas. No studies have directly compared tenecteplase and reteplase in patients with ST-elevation myocardial infarction (STEMI). 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.https://doi.org/10.1177/10760296251316876 |
| spellingShingle | Adham Mohamed PharmD Sara Mahmoud PharmD Amr M. Fahmi PhD Ahmed Mahfouz MSc Tayseer Kanaan MD Jihad Jaber MD Mansour Alkhawi MD Saleh Alkhalaf MD Hassan Kodimi MD Ahmed Shaaban MD Omar Alshibli MD Awad Almasalmeh MD Salaheddin Arafa MD Salah Elbdri MD Suhail Falah MD Fayez Altrad MD Ezeldin Soaly MD Rasha Elenany PharmD Sumaya Alyafei PharmD Abdul Rahman Arabi MD Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort Study Clinical and Applied Thrombosis/Hemostasis |
| title | Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort Study |
| title_full | Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort Study |
| title_fullStr | Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort Study |
| title_full_unstemmed | Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort Study |
| title_short | Tenecteplase vs Reteplase in Patients with Acute ST-Elevation Myocardial Infarction: A Retrospective Cohort Study |
| title_sort | tenecteplase vs reteplase in patients with acute st elevation myocardial infarction a retrospective cohort study |
| url | https://doi.org/10.1177/10760296251316876 |
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