Author/Authors :
Yazdi, Amir Hossein School of Medicine - Hamedan University of Medical Sciences, Hamedan, I.R. Ira , Khalilipur, Ehsan Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, I.R. Iran , Zahedmehr, Ali Cardiovascular Intervention Research Center - Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, , Amiri Pouya, Saeed Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, I.R. Iran , Pakrou, Maryam Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, I.R. Iran , Ghaznavi, Mohammad Ali Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, I.R. Iran , Mikaelvand, Amir Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, I.R. Iran , Rouzitalab, Mostafa Rajaie Cardiovascular, Medical, and Research Center - Iran University of Medical Sciences, Tehran, I.R. Iran
Abstract :
Background: Although primary percutaneous intervention (PCI) is the preferred reperfusion
strategy in patients with STEMI, not all patients are good candidates for PCI—mainly
because of a delay in requesting medical care and longer 1st medical contact to balloon time.
The objective of this study was to compare the efficacy and side effects of 2 known
fibrinolytic therapies, streptokinase (SK) and tenecteplase (TNK).
Methods: This descriptive, analytic cross-sectional study recruited patients not amenable to primary
PCI. From a total of 142 patients recruited, 88 patients received SK and the other 54 patients
received TNK. Thereafter, the efficacy of the agents, their side effects, territory of the
culprit vessel, minor and major bleeding, relation to diabetes mellitus, and mortality in the
index hospitalization were compared.
Results: Patients who were administered SK showed a 2.09-mm ST elevation after the drug
administration as opposed to 1.95 mm in the TNK group (P=0.340). Minor bleeding was
reported in 22.7% of the SK group and 24.1% in the TNK group. Major bleeding in the SK
and TNK groups was 11.1% and 5.7%, respectively, with no significant difference. In the
patients’ index admission, death due to STEMI occurred in 10 (11.4%) patients in the SK
group and 8 (14%) patients in the TNK group; the difference did not constitute statistical
significance.
Conclusions: The results of our study showed that SK and TNK were similar in terms of major
complications, mortality rates, and efficacy. Thus, if TNK is not available, SK would be a
reasonable choice.
Keywords :
ST elevation MI , Primary PCI , Fibrinolytic therapy , Streptokinase , Tenecteplase