CLINICAL RESULTS OF THROMBOLYTIC THERAPY WITH ALTEPLASE AND TENECTEPLASE IN PATIENTS WITH MYOCARDIAL INFARCTION
https://doi.org/10.20996/1819-6446-2012-8-5-685-690
Abstract
Aim. To evaluate the clinical results of thrombolytic therapy with thrombolytics (alteplase, tenecteplase) in patients with ST segment elevation myocardial infarction (STEMI). Material and methods. Patients with STEMI (n=181) included in the study were split into two groups depending on the thrombolytic agent: patients treated with alteplase - group 1 (n=78); patients treated with tenecteplase — group 2 (n=52). Patients with STEMI who had no thrombolysis due to late treatment-seeking or the presence of contraindications were included into the group 3 (n=51). Thrombolysis took place both in pre-hospital and in-hospital period. Time before the thrombolysis, STEMI clinical course, mortality , and complications were analyzed. Results. The average time pain-thrombolysis was 2.7±0.22 hours. High efficacy of both thrombolytic drugs was proved in the most of patients. Mortality in patients received thrombolysis was 6.4–7.7%; this in patients without thrombolytic therapy — 24%. Thrombolysis performed in the first 3 hours after STEMI onset reduced mortality to 3.4%. No one intracranial hemorrhage or allergic reaction was registered. Conclusion. Thrombolytic therapy with alteplase and tenecteplase in patients with STEMI in the real clinical practice was high efficient, reduced hospital mortality and induced a few adverse reactions.
About the Authors
L. A. Bondarenko
Medical Institute of Penza State University
City Emergency Clinical Hospital named after G.A. Zakhar'in
Russian Federation
Russian Federation
L. E. Rudakova
Medical Institute of Penza State University
Russian Federation
Russian Federation
F. K. Rakhmatullov
Medical Institute of Penza State University
Russian Federation
Russian Federation
T. P. Kostrikova
City Emergency Clinical Hospital named after G.A. Zakhar'in
Russian Federation
Russian Federation
I. I. Kapustina
City Emergency Clinical Hospital named after G.A. Zakhar'in
Russian Federation
Russian Federation
References
1. Shpektor A.V., Vasil'eva E.Iu., Artamonov V.G. et al. Combined reperfusion in patients with acute myocardial infarction. Kardiologiia 2007;47(6):27–30.Russian (Шпектор А.В., Васильева Е.Ю., Артамонов В.Г. и др. Комбинированная реперфузия у больных острым инфарктом миокарда. Кардиология 2007; 47 (6): 27–30).
2. Yavelov I.S. Thrombolysis in myocardial infarction: is to know the practitioner. Trudnyy Patsient 2011; 9 (1): 7–13. Russian (Явелов И.С. Тромболитическая терапия при инфаркте миокарда: что надо знать практикующему врачу. Трудный пациент 2011; 9 (1): 7–13).
3. Poponina T.M., Poponina Yu.S., Vasil'ev A.G. The risks and benefits of reperfusion strategies in the treatment of patients with acute myocardial infarction with ST segment elevation. Rossiyskiy Kardiologicheskiy Zhurnal 2010; (5): 103–113.Попонина Т.М., Попонина Ю.С., Васильев А.Г. Риск и выгода реперфузионных стратегий в лечении больных острым инфарктом миокарда с подъемом сегмента ST. Российский Кардиологический Журнал 2010; (5): 103–113.
4. Ioseliani D.G., El'kis I.S., Solov'ev O.P. et al. Combination of prehospital systemic thrombolytic therapy with endovascular procedures in the treatment of patients with acute myocardial infarction Kardiologiia 2005;45(3):4–9. Russian (Иоселиани Д.Г., Элькис И.С., Соловьев О.П. и др. Комбинация эндоваскулярных процедур и догоспитальной системной тромболитической терапии при лечении больных острым инфарктом миокарда. Кардиология 2005; (3): 4–9).
5. Тhe Global Use of Strategies to Open Occluded Coronary Arteries (Gusto III) Investigators. A comparison of reteplase with alteplase for acute myocardial infarction. N Engl J Med 1997; 337: 1118–1123.
6. Dovgalevskiy P.Ya., Furman N.V., Dovgalevkiy Ya.P. The efficacy and safety of thrombolytic therapy of myocardial infarction with ST-segment elevation by tenecteplase in actual clinical practice. Skoraya Meditsinskaya Pomoshch' 2009; (3): 43–49. Russian Довгалевский П.Я., Фурман Н.В., Довгалевкий Я.П. Эффективность и безопасность тромболитической терапии инфаркта миокарда с подъемом сегмента ST тенектеплазой в реальной клинической практике. Скорая Медицинская Помощь 2009; (3): 43–49.
7. Iavelov I.S. The use of tenecteplase in acute myocardial infarction. Kardiologiia 2007;47(1):37–46. Russian (Явелов И.С. Применение тенектеплазы при остром инфаркте миокарда. Кардиология 2007; 47(1): 37–46).
8. Shostak N.A., Konstantinova E.V. Alteplase administration in patients with ST-segment elevation acute myocardial infarction in typical clinical practice. Kardiologiia. 2005;45(9):26–8. Russian (Шостак Н.А., Константинова Е.В. Применение альтеплазы у больных острым инфарктом миокарда с подъемами сегмента ST на ЭКГ в типичной клинической практике. Кардиология 2005; 45(9): 26–28).
9. Demidova M.M., Tikhonenko V.M., Burova N.N. Assessment of the state of a patient with acute coronary syndrome during thrombolytic therapy with the use of multichannel ECG-monitoring. Kardiologiia 2009;49(7–8):25–31. Russian (Демидова М.М., Тихоненко В.М., Бурова Н.Н. Оценка состояния больного острым коронарным синдромом при проведении тромболитической терапии с использованием 12-ти канального мониторирования электрокардиограммы. Кардиология 2009; 49(7): 25–31).
10. The TIMI Research Group. The thrombolysis in myocardial infarction (TIMI) trial. Phase I Findings. N Eng J Med 1985; 312: 932–936.
11. Verstraete M., Bernard R., Bory M. et al. Randomised trial of intravenous recombinant tissue-type plasminogen activator versus intraveus streptokinase in acute myocardial infarction. Report from the Europen Cooperative Studi Group for Recombinant Tissue-type Plasminogen Activator. Lancet 1985; 13: 842–848.
12. Yavelov I.S. The role of low molecular weight heparin with thrombolytic therapy in patients with myocardial infarction. Kardiovaskulyarnaya Terapiya i Profilaktika 2009; 8 (6): 111–122. Russian (Явелов И.С. Роль низкомолекулярных гепаринов при тромболитической терапии у больных инфарктом миокарда. Кардиоваскулярная терапия и профилактика 2009; 8 (6): 111–122).
13. Panchenko E.P. Thrombolytic agents in the treatment of patients with acute myocardial infarction. Atmosfera. Kardiologiya 2001; (1): 16–20. Russian (Панченко Е.П. Тромболитические препараты в лечении больных острым инфарктом миокарда. Атмосфера. Кардиология 2001; (1): 16–20).
14. Dolzhenko M.N., Dovganich N.V. Reperfusion arrhythmias: a new look at an old problem. Meditsina Neotlozhnykh Sostoyaniy 2008; 3 (16): 43–47. Russian (Долженко М.Н., Довганич Н.В. Реперфузионные аритмии: новый взгляд на старую проблему. Медицина Неотложных Состояний 2008; 3 (16): 43–47).
15. Furman N.V., Dovgalevskiĭ Ia.P., Shchetinkina I.N. Early reperfusion and aborted myocardial infarction. Kardiologiia 2009;49(11):89–92. Russian (Фурман Н.В., Довгалевский Я.П., Щетинкина И.Н. Ранняя реперфузия и прерванный инфаркт миокарда. Кардиология 2009; (11): 89–92).
Review
For citations:
Bondarenko L.A., Rudakova L.E., Rakhmatullov F.K., Kostrikova T.P., Kapustina I.I. CLINICAL RESULTS OF THROMBOLYTIC THERAPY WITH ALTEPLASE AND TENECTEPLASE IN PATIENTS WITH MYOCARDIAL INFARCTION. Rational Pharmacotherapy in Cardiology. 2012;8(5):685-690. (In Russ.) https://doi.org/10.20996/1819-6446-2012-8-5-685-690
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