Tenecteplase versus alteplase after acute ischemic stroke at high age

特奈特普酶 医学 改良兰金量表 纤溶剂 冲程(发动机) 优势比 置信区间 组织纤溶酶原激活剂 内科学 随机对照试验 溶栓 缺血性中风 缺血 心肌梗塞 机械工程 工程类
作者
Bente Thommessen,Halvor Næss,Nicola Logallo,Christopher Elnan Kvistad,Ulrike Waje‐Andreassen,Hege Ihle‐Hansen,Håkon Ihle‐Hansen,Lars Thomassen,Ole Morten Rønning
出处
期刊:International Journal of Stroke [SAGE Publishing]
卷期号:16 (3): 295-299 被引量:20
标识
DOI:10.1177/1747493020938306
摘要

Background Stroke prevalence is increasing with age. Alteplase is the only agent approved for thrombolytic treatment for patients with ischemic stroke, including patients ≥80 years. In the present study, the aim was to compare efficacy and safety of tenecteplase and alteplase in patients ≥80 years. Methods Data from the Norwegian Tenecteplase Stroke Trial, a randomized controlled trial comparing alteplase and tenecteplase, were assessed. Results Of the 273 patients ≥80 years included, mean age was 85.5 years. In the intention-to-treat analyses, 43.1% receiving tenecteplase and 39.9% receiving alteplase reached excellent functional outcome (modified Rankin Scale score 0–1) after 3 months (odds ratio (OR) 1.14, 95% confidence interval (CI) 0.70–1.85, p=0.59). No significant differences among patients in the two treatment groups regarding frequency of symptomatic intracranial hemorrhage during the first 48 h were identified (11 (8.5%) in the tenecteplase group, 10 (7.0%) in the alteplase group, OR 1.23, 95% CI 0.50–3.00, p 0.65). Death within 3 months occurred in 18 patients (14.3%) in the tenecteplase group and in 21 (15.3%) in the alteplase group (p 0.84). After excluding stroke mimics, the proportion of patients with excellent functional outcome was 44.1% in the tenecteplase group and 34.4% in the alteplase group (OR 1.50 CI 0.90–2.52, p 0.12). Conclusion No differences in the efficacy and safety of tenecteplase versus alteplase in patients ≥80 years were identified. Trial registration Clinicaltrials.gov (NCT01949948)
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