A Comparison of Tenecteplase(TNK-tPA) and Alteplase(rt-PA) in Korean Patients with Acute Myocardial Infarction(A Randomized, Multi-Centered Coronary Angiographic Trial).
10.4070/kcj.2003.33.5.362
- Author:
Myung Ho JEONG
1
;
Weon KIM
;
Jung Chaee KANG
;
Seong Wook HAN
;
Seung Ho HUR
;
Kwon Bae KIM
;
Kwang Soo CHA
;
Moo Hyun KIM
;
Heung Sun KANG
;
Jong Hwa BAE
;
In Ho CHAE
;
Byung Hee OH
;
Myeong Ki HONG
;
Seong Wook PARK
;
Seung Jung PARK
;
So Yeon CHOI
;
Seung Jae TAHK
;
Dong Hoon CHOI
;
Yang Soo JANG
;
Seung Yun CHO
;
Byung Su YOO
;
Jung Han YOON
;
Kyung Hoon CHOE
Author Information
1. Chonnam National University Hospital, Gwangju, Korea. jckang@chonnam.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Coronary disease;
Myocardial infarction;
Thrombolysis, therapeutic;
Myocardial revascularization;
Survival
- MeSH:
Arteries;
Body Weight;
Coronary Disease;
Emergency Service, Hospital;
Humans;
Infusions, Intravenous;
Mortality;
Myocardial Infarction;
Myocardial Revascularization;
Risk Factors;
Thrombolytic Therapy
- From:Korean Circulation Journal
2003;33(5):362-373
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: This is a comparative, randomized, multi-centered, angiographic trial for the comparison of TNK-tPA with rt-PA, in Korean patients with an acute myocardial infarction (AMI). SUBJECTS AND METHODS: Fifty four patients that were eligible for thrombolysis, diagnosed with an AMI, were randomized into two groups:TNK-tPA (single bolus injection, 25-50 mg weight adjusted;n=25) or rt-PA (accelerated intravenous infusion, up to 100 mg;n=29) at the emergency room. The primary endpoint was the percentage of patients with a TIMI (Thrombolysis In Myocardial Infarction) III flow 90 min following the administration of the study drug. The secondary endpoints were an infarct-related artery patency at 90 min, the percentage of patients with ST segment resolution at 60 and 180 min, and at 30 days mortality. RESULTS: The baseline demographic data, including age, sex and body weight, and a medical history of prior myocardial infarction and risk factors were no different between the TNK-tPA and rt-PA groups. The pain-to-needle and door-to-needle times were also no different. The ST segment resolution was no different between the two groups. A TIMI grade 3, on a coronary angiogram, 90 min following the drug administration, was observed in 19 (76.0%) of the TNK-tPA and 17 (58.6%) of the rt-PA (p=0.24) patients. However, a TIMI grade more than 2 was higher in the TNK-tPA (100%;25/25) than in rt-PA group (72.4%;21/29)(p=0.0052). The in-hospital adverse events, and clinical outcomes at 30 days, were no different between the two groups. CONCLUSION: TNK-tPA is more convenient, and may be a preferred thrombolytic agent, for the revascularization of an AMI.