- 作者：Emilio Curiel Balsera ; emiliouci@telefonica.net ; Miguel Á ; ngel Prieto Palomino ; Juan Mora Ordoñ ; ez ; Carmen Ló ; pez Caler ; Teresa Garcí ; a Paredes ; Guillermo Quesada Garcí ; a
- 关键词：Fibrinó ; lisis ; Hemorragia ; Reperfusió ; n ; Alteplasa ; Tenecteplasa
- 刊名：Cardiocore
- 出版年：2011
- 期刊代码：pca84_1889898X
- 类别：med
- 出版时间：October-December 2011
- 卷：46
- 期：4
- 页码：150-154
- 文件大小：256 K
Introduction
The importance of early administration of fibrinolytic therapy in ST elevated myocardial infarction (STEMI), with the aim of reducing mortality, is universally accepted and endorsed by many publications. Our objective was to determine whether the fibrinolytic reperfusion with tenecteplase (TNK) was less effective than that obtained with alteplase (rt-PA), and also to analyse the safety of both agents.
Methodology
A retrospective observational study was conducted on patients admitted to our ICU between 2005-2008 due to an STEMI, and treated with one of these two thrombolytic agents. Clinical and angiographic criteria data were used to evaluate the effectiveness of fibrinolysis, bleeding complications and the intra-ICU mortality rate.
Results
Of the 453 patients who met the inclusion criteria, 286 were treated with TNK and 167 with rt-PA. Both groups were homogeneous and no difference was found between them regarding the effectiveness parameters (pain management, myoglobin ratio or ST depression). Artery re-occlusion in patients who already met the criteria for effective fibrinolysis was higher in the TNK group (22.5%vs. 11.6%, P=.04). In the 346 patients who underwent coronary angiography within 72 h (203 in the group treated with TNK and 143 in the group treated with rt-PA), closed arteries were open (TIMI 3) in 28.4%and 53.9%respectively (P=.001). There were no significant differences in bleeding complications between both groups, however less bleeding was observed with TNK. There were no differences in mortality rate between both groups.
Conclusions
Both drugs showed a similar rate of reperfusion, although there was a smaller percentage of re-occlusions with rt-PA. The complication rate did not differ in both groups, although TNK seemed to be less harmful, especially at the expense of extracranial bleeding.