Treatment of Acute Stemi with Thrombolysis: Tenecteplase Vs. Streptokinase

Šerpytis, Pranas; Bilkis, Valdas; Kakliorius, Robertas; Kūgienė, Rasa; Žvironaitė, Vida; Katkus, Rimgaudas; Jarašūnienė, Dalia; Klimas, Nerijus; Žebrauskaitė, Aistė; Berūkštis, Egidijus; Kačiurinas, Dmitrijus

doi:10.5200/sm-hs.2012.107

Cited by 5 publications

(8 citation statements)

References 18 publications

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“…In our study 13 (75%) patients were treated with streptokinase and 7 (25%) patients were treated with tenecteplase which was similar to the study conducted by Ehsan Khalilipur were 88(62%) were treated with streptokinase and 54(38%) with tenecteplase 15. ST resolution in the 2 groups after thrombolytic therapy was 1.07mm in streptokinase group and 0.42mm in tenecteplase group (P value=0.06) which was complementary to study conducted by Amir Hossein Yazdi et.al., 16 gave the result that ST resolution in 2 groups after thrombolytic therapy is 0.81mm in streptokinase group and 1.02 mm in tenecteplase group (P value=0.340).…”

Section: Discussionmentioning

confidence: 98%

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Impact of Streptokinase and Tenecteplase on Electrocardiogram (St-Segment) and Two Dimensional-Echocardiography (Regional Wall Motion Abnormalities) in St Elevated Myocardial Infarction

Naini¹,

Punzuri²,

Reddy³

et al. 2019

Int. Res. J. Pharm.

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Background: One of the most striving problem among coronary artery disease is ST elevated myocardial infarction. It is the infarction in which entire wall of coronary artery gets occluded and is associated with ST segment elevation (>2mm in atleast 2 chest leads or >1mm in precordial leads or limb leads) on ECG. The impact of Streptokinase and Tenecteplase on ECG and 2D-echo in patients with ST elevated myocardial infarction and the effect of timing of thrombolytic therapy were compared. Material and methods: Patients presented with chest pain within 12 hours diagnosed with st elevated myocardial infarction and received thrombolytic therapy is included in our study. Results: 40 patients were recruited for our study. 20 patients were excluded because of their advice to higher centres due to their critical condition and not available for follow up. ST elevated myocardial infarction patients who were taking streptokinase 1.5 million units and tenecteplase 40 mg completed the study. Among 20 patients 13 (65%) patients treated with streptokinase and 7 (35%) patients treated with tenecteplase. After 30 days follow up 2D echo reveals regional wall motion abnormalities in 10 patients of Streptokinase group and 2 patients of Tenecteplase group. Regional wall motion abnormalities was absent in 3 patients of Streptokinase group and 5 patients of Tenecteplase group. Conclusion: From this study we demonstrate that tenecteplase was more efficacious than streptokinase in terms of ECG readings (ST resolution), 2D-echo. Patients who were presented within 6 hours have benefited more.

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Section: Discussionmentioning

confidence: 98%

“…In our study patients who received tenecteplase and streptokinase had 43% and 23% of complete resolution respectively which is similar to study where Pranas Serpytis et.al. 16 had showed that tenecteplase restores the blood flow better than streptokinase.…”

Section: Discussionmentioning

confidence: 99%

Impact of Streptokinase and Tenecteplase on Electrocardiogram (St-Segment) and Two Dimensional-Echocardiography (Regional Wall Motion Abnormalities) in St Elevated Myocardial Infarction

Naini¹,

Punzuri²,

Reddy³

et al. 2019

Int. Res. J. Pharm.

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“…The following contra-indication precludes the use of fibrinolytic agents: recent internal hemorrhage, intracerebral hemorrhage, ischemic stroke within the last six months, pregnancy, uncontrolled high blood pressure, major surgery, recent trauma with resuscitation, etc. [ 66 ].…”

Section: Reviewmentioning

confidence: 99%

“…However, a meta-analysis of four observational studies of direct comparison of SK and TNK reported a similar risk of bleeding between the two agents [ 77 ]. Some high-income countries also reached varying conclusions, although the type of bleeding was not specified; in their study conducted in Lithuania, Serpytis et al reported no bleeding risk in both arms [ 66 ]. In contrast, Chau et al reported a similar bleeding risk in their study in Hong Kong [ 75 ].…”

Section: Reviewmentioning

confidence: 99%

A Systematic Review of the Efficacy and Safety of Tenecteplase Versus Streptokinase in the Management of Myocardial Infarction in Developing Countries

Muoghalu,

Ekong,

Wyns

et al. 2023

Cureus

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Myocardial infarction (MI) is a significant cause of morbidity and mortality in low- and middle-income countries. Fibrinolytic agents and percutaneous coronary intervention (PCI) are the main approaches for the recanalization and reperfusion of the myocardium following MI. Many studies have shown that PCI is superior to thrombolytics due to better outcomes and decreased mortality. Nevertheless, PCI's mortality gain over thrombolysis decreases as the time between presentation and PCI procedure increases. Furthermore, PCI is not widely available in most developing countries; thus, it cannot be delivered promptly. Most patients in developing countries cannot afford the cost of PCI. Thus, thrombolytic therapy remains essential to managing MI in developing countries and should not be disregarded. Tenecteplase (TNK) and streptokinase (SK) are the two most widely used fibrinolytics in managing MI in underdeveloped nations. Despite their widespread availability, comparative studies on them have been inconclusive. This study aims to review the available literature on the effectiveness and safety of TNK versus SK in managing MI in resource-poor nations. The study is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) extension and analyzed according to Cochrane guidelines on synthesis without meta-analysis. A comprehensive literature search for studies comparing TNK and STK was conducted on EMBASE, Cochrane Library, Web of Science, CINAHL, Scopus, Google Scholar, and Ovid version of MEDLINE databases. A reference list of the eligible articles and systematic reviews was also screened. A narrative synthesis of the available data was done by representing the data on the effect direction plot, followed by vote counting. Of the 2284 references retrieved from the databases, only 17 studies met the inclusion criteria and were selected for final analysis. The study suggested that TNK is more effective in complete ST-segment resolution (80% vs 10% on the effect direction plot) and symptom relief (80% vs 20%) than SK. SK and TNK were comparable in achieving successful fibrinolysis (50% vs 50%). For the safety parameters, TNK is associated with a lesser risk of major bleeding than SK (88.9% vs 11.1%) and minor bleeding (25% vs 75%). SK was linked with a higher risk of hypotension/shock (77.8% vs 11.1%) and anaphylaxis/allergy (100% vs 0%). Long-term mortality was higher in the SK arm (100% vs 0%). In-hospital mortality is comparable between the two agents (37.5% vs 37.5%). There is conflicting evidence regarding other safety and efficacy endpoints. Compared to SK, TNK results in better complete ST-segment resolution and symptom relief. A higher risk of long-term mortality, increased risk of major and minor bleeding, hypotension, and allergy/anaphylaxis was observed in patients who received SK. Both agents were comparable in terms of in-hospital mortality and successful fibrinolysis. Controversy exists regarding which agent is linked with increase...

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“…They discussed a cross-sectional retrospective analysis where streptokinase was used in 93% of patients of the 20% of STEMI patients who were thrombolysed, which have shown lower overall 1 year mortality rate (2.5%) with interventional approach or pharmacotherapy. [ 32 ] They were of the opinion that although streptokinase is cheap and tenecteplase is costly, the use of tenecteplase as a single bolus has better TIMI scores which will especially be useful in a country India where already a greater delay is observed from symptom onset to management. It has also been observed in a previous study that better TIMI scores have resulted in better protection of myocardium.…”

Section: P Roblems With T Roponin mentioning

confidence: 99%

Expert consensus document on management of ST-Elevation myocardial infarction: Adaptation of 2012 ESC guidelines

Nair

Agrawal²,

Dutta

et al. 2018

Indian Journal of Critical Care Medicine

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In 2012, the European Society of Cardiology (ESC) guidelines provided recommendations on the management of ST-elevation myocardial infarction (STEMI). The recommendation from these guidelines is restricted to the European subcontinent. To adapt the updated recommendations for Indian subset of STEMI patients, a panel of experts in the management of STEMI provided their expert opinions. This document provides expert consensus on adapting 2012 ESC STEMI guidelines recommendations in Indian setting. Document also discussed “India-specific” relevant literature to support the consensus opinions provided in the management of STEMI.

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Treatment of Acute Stemi with Thrombolysis: Tenecteplase Vs. Streptokinase

Cited by 5 publications

References 18 publications

Impact of Streptokinase and Tenecteplase on Electrocardiogram (St-Segment) and Two Dimensional-Echocardiography (Regional Wall Motion Abnormalities) in St Elevated Myocardial Infarction

Impact of Streptokinase and Tenecteplase on Electrocardiogram (St-Segment) and Two Dimensional-Echocardiography (Regional Wall Motion Abnormalities) in St Elevated Myocardial Infarction

A Systematic Review of the Efficacy and Safety of Tenecteplase Versus Streptokinase in the Management of Myocardial Infarction in Developing Countries

Expert consensus document on management of ST-Elevation myocardial infarction: Adaptation of 2012 ESC guidelines

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