Half-Dose Tenecteplase or Primary Percutaneous Coronary Intervention in Older Patients With ST-Segment-Elevation Myocardial Infarction in STREAM-2: A Randomized, Open-Label Trial

CONCLUSIONS: Halving the dose of tenecteplase in a pharmaco-invasive strategy in this early-presenting, older STEMI population was associated with electrocardiographic changes that were at least comparable to those after primary PCI. Similar clinical efficacy and angiographic end points occurred in both treatment groups. The risk of intracranial hemorrhage was higher with half-dose tenecteplase than with primary PCI. If timely PCI is unavailable, this pharmaco-invasive strategy is a reasonable alternative, provided that contraindications to fibrinolysis are observed and excess anticoagulation is avoided.REGISTRATION: URL: https://www.CLINICALTRIALS: gov; Unique identifier: NCT02777580.PMID:37439219 | DOI:10.1161/CIRCULATIONAHA.123.064521

Source: Circulation - July 13, 2023 Category: Cardiology Authors: Frans Van de Werf Arsen D Risti ć Oleg V Averkov Alexandra AriasMendoza Yves Lambert Jos é F Kerr Saraiva Pablo Sepulveda Fernando Rosell-Ortiz John K French Ljilja B Musi ć Katleen Vandenberghe Kris Bogaerts Cynthia M Westerhout Alain Pag ès Thierry Source Type: research