Comparison of tenecteplase versus alteplase in STEMI patients treated with ticagrelor: A cross-sectional study

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dc.contributor.authorGunlu, Serhat
dc.contributor.authorDemir, Muhammed
dc.date.accessioned2024-04-24T16:10:44Z
dc.date.available2024-04-24T16:10:44Z
dc.date.issued2022
dc.departmentDicle Üniversitesien_US
dc.description.abstractBackground: The effectiveness and safety of administration of ticagrelor simultaneously with fibrinolytic agents in STEMI patients remain unclear.Objective: This study aimed to investigate the effectiveness and safety of tenecteplase against alteplase in patients with STEMI receiving a loading dose of ticagrelor.Methods: We conducted a cross-sectional study in patients with STEMI who were reperfused with fibrinolytic. The study included 150 patients (ages 18 to 75 years) administered tenecteplase or alteplase and concomitantly given ticagrelor [180 mg loading dose, 90 mg bid (bis in die)]. Patients who had active major bleeding, died, and who were decided to have a CABG surgery as a result of coronary angiography were excluded. Patients who underwent facilitated-PCI with fibrinolysis continued to receive ticagrelor without switching to clopidogrel. The MACE (in-hospital death, TIMI flow grade, major bleeding) rates of the two groups were compared.Results: The study consisted of 150 patients, comprising 99 (66%) men and 51 women (34%) with a mean age of 60,33 +/- 13,83 years. Patients were divided into two groups according to the thrombolytic therapy: alteplase (n = 60) and tenecteplase (n = 90). The major adverse cardiac events (MACE) (45% vs 22.2%), bleeding (11.7% vs 2.2%), hypertension (51.7% vs 30%), atrial fibrillation (26.7% vs 12.2%), left ventricular hypertrophy (26.7% vs 10%), CRP (p < 0.001) were significantly higher and the recanalization (66.7% vs 85.4%), hematocrit (p = 0.03) were significantly lower in the alteplase group compared to the tenecteplase group. No significant differences were found between the two groups about in-hospital mortality (p = 0.151). Kaplan Meier analysis was performed in terms of MACE (TIMI flow grade 1, major bleeding, in-hospital mortality) rates during the followup period (Log-rank test, p = 0.032). Patients who received tenecteplase treatment had a lower MACE, according to a Kaplan-Meier analysis.Conclusions: The administration of tenecteplase in STEMI patients who received a loading dose with ticagrelor resulted in a significant reduction in MACE compared to alteplase. Larger multi-center studies are warranted to investigate the effect of tenecteplase treatment on clinical results.(c) 2022 Elsevier Inc. All rights reserved.en_US
dc.identifier.doi10.1016/j.ajem.2022.05.021
dc.identifier.endpage56en_US
dc.identifier.issn0735-6757
dc.identifier.issn1532-8171
dc.identifier.pmid35636043
dc.identifier.scopus2-s2.0-85132411861
dc.identifier.scopusqualityQ1
dc.identifier.startpage52en_US
dc.identifier.urihttps://doi.org/10.1016/j.ajem.2022.05.021
dc.identifier.urihttps://hdl.handle.net/11468/15070
dc.identifier.volume58en_US
dc.identifier.wosWOS:000808614800010
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherW B Saunders Co-Elsevier Incen_US
dc.relation.ispartofAmerican Journal of Emergency Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAntiaggreganten_US
dc.subjectThrombolytic Treatmenten_US
dc.subjectStemien_US
dc.subjectTicagreloren_US
dc.subjectBleedingen_US
dc.titleComparison of tenecteplase versus alteplase in STEMI patients treated with ticagrelor: A cross-sectional studyen_US
dc.titleComparison of tenecteplase versus alteplase in STEMI patients treated with ticagrelor: A cross-sectional study
dc.typeArticleen_US

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