PP 87 STREPTOKINASE VERSUS TENECTEPLASE FOR ACUTE MYOCARDIAL INFARCTION

Abstract

INTRODUCTION

Tenecteplase is new generation of fibrin specific thrombolysis. It is perceived as higher superiority in terms of efficacy, complications and mortality as compared to streptokinase. There is limited literature comparing tenecteplase and streptokinase.

MATERIALS & METHOD

This is prospective cross sectional study of convenient sampling in Hospital Umum Sarawak over a period of 6 months. Patient was diagnosed and treated as MI by attending physicians. The choice of thrombolysis is at discretion of the treating doctors. Outcome data was collected in ED or Cardiology centre, Sarawak. The criteria for successful reperfusion include resolution of ST elevation of at least 50%, resolution of symptoms, and improvement of clinical pictures. RESULTS 45 patients were enrolled in this study. Our patients were predominantly male (93.3%), Bumiputera in origin (64.4%) with a mean age of 59 years old. 62.3% were smokers and 64.6% has at least 1 premorbid condition. 22 patients were given tenecteplase, with 6 failed reperfusion. 23 patients received streptokinase, with 5 patients failed thrombolysis. 62.2% of the lesion arise from the left coronary artery. Rate of mild bleeding is similar between both group. There is no major bleeding in this cohort.

DISCUSSION

From our data, there’s no different in success rate or bleeding rate between tenecteplase and streptokinase regardless of demographic or type of coronary lesion. Larger prospective RCT study is needed to confirm our findings.