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

Abstract

The aim of this study – to compare the efficacy of streptokinase with tenecteplase, while treating patients with ST elevated acute myocardial infarction by thrombolysis. To evaluate, how these agents affect TIMI blood flow, using coronarography. To compare bleeding complications between streptokinase and tenecteplase groups. The study material and methods. The analysis of 240 patients was performed. 118 patients were treated with tenecteplase vs. 122 with streptokinase during a period of 2005-2008 in various Lithuanian hospitals. Thrombolytic treatment was administered within 6 hours from the onset of myocardial infarction symptoms. Coronarography was carried out within 24 hours from the onset of myocardial infarction symptoms. Results. Coronarography showed the rate of TIMI-3 blood flow in 88 (74.5%) patients of the tenecteplase group. In the streptokinase group TIMI-3 was established in 39 patients (31.9%). The TIMI-2 blood flow in the tenecteplase group was established in 22 patients (18.6%), and 25 patients (20.5%) in the streptokinase group. TIMI-1 blood flow was found in 5 patients (11.2%) in the tenecteplase group and in 20 patients (16.5%) in the streptokinase group. TIMI-0 was found in 3 patients (2.6%) in the tenecteplase group and in 36 patients (31.1%) in the streptokinase group. There were no marked bleeding registered in either of the groups. Conclusions. Tenecteplase restores the blood flow in the infarction related coronary artery better than streptokinase.

doi:10.5200/sm-hs.2012.107

Keyword(s): STEMI; thrombolysis; tenecteplase; streptokinase
DOI: 10.5200/352
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