Big fucking whoopee.
'Care'! But you tell us NOTHING ABOUT RESULTS. They remind us they are faster and shorter treatment times but never tell us how many 100% recovered. You have to ask yourself why they are hiding their incompetency by not disclosing recovery results. ARE THEY THAT FUCKING BAD?
Tenecteplase Speeds Acute Ischemic Stroke Care
The thrombolytic agent tenecteplase was associated with shorter treatment and transfer times than alteplase in patients with acute ischemic stroke, a large US registry analysis showed.
“These workflow advantages provide support for broader use of tenecteplase for stroke thrombolysis,” said the investigators led by Steven J. Warach, MD, PhD, of Dell Medical School at The University of Texas at Austin.
Even modest reductions in treatment time may translate into clinically meaningful benefits because earlier reperfusion is strongly linked to improved stroke outcomes(Survivors want 100% recovery OR DON'T YOU CARE ABOUT THAT?), the investigators noted.
The findings were published online on July 13 in JAMA Network Open.
- Tenecteplase ↓ DTN vs alteplase in AIS; mean difference 3.1 minutes.
- 30% achieved DTN ≤30 min with tenecteplase vs 20.4% with alteplase.
- Tenecteplase also improved DIDO and thrombectomy workflow times.
- Hospitals switching from alteplase to tenecteplase showed modest DTN improvement.
- Registry data support broader tenecteplase use; nonrandomized confounding remains possible.
Faster Treatment Across Multiple Workflow Measures
Intravenous (IV) alteplase has long been the standard thrombolytic therapy for acute ischemic stroke, but tenecteplase has gained increasing acceptance because it can be administered as a single IV bolus rather than as a bolus followed by a 60-minute infusion.
To investigate, Warach and colleagues analyzed data from the American Heart Association (AHA) Get With The Guidelines-Stroke registry, which captures more than 75% of stroke admissions in the US.
The cohort included 133,228 adults treated with IV thrombolysis for acute ischemic stroke between July 2020 and June 2022 across 2092 hospitals. Of these, 13,988 patients (10.5%) received tenecteplase and 119,240 (89.5%) received alteplase.
Among patients treated at the presenting hospital, the average door-to-needle (DTN) time was 47.0 minutes with tenecteplase compared with 52.7 minutes with alteplase, a mean difference of 3.1 minutes favoring tenecteplase.
Patients receiving tenecteplase were also significantly more likely to achieve key DTN benchmarks. Nearly 30% of patients receiving tenecteplase were treated within 30 minutes compared with 20.4% of those receiving alteplase, whereas 58.3% vs 48.6% met the 45-minute target and 77.5% vs 70.7% achieved treatment within 60 minutes.
Hospitals that transitioned from alteplase to tenecteplase during the study period also experienced modest improvements in average DTN time after making the switch.
The benefits of tenecteplase extended to patients requiring transfer for higher-level care(NOT REOVERY!). Among likely mechanical thrombectomy candidates, mean door-in-door-out (DIDO) time was 108.3 minutes with tenecteplase vs 114.1 minutes with alteplase, an adjusted reduction of nearly 6 minutes. Patients transferred overall also had significantly shorter DIDO times with tenecteplase.
Tenecteplase was also associated with faster endovascular treatment once patients underwent thrombectomy. Compared with alteplase, tenecteplase was associated with shorter door-to-arterial puncture, door-to-device deployment, and door-to-reperfusion times among both transferred patients and those treated at thrombectomy-capable centers.
Support for Broader Use
The researchers acknowledged several limitations. Because it was based on a voluntary, nonrandomized registry, residual confounding cannot be excluded despite statistical adjustment.
The participating hospitals were largely early adopters of tenecteplase and tended to be higher-volume certified stroke centers, potentially limiting generalizability to smaller or less experienced hospitals. In addition, missing workflow data were not imputed and may not have occurred at random.
Despite these limitations, the findings suggest that tenecteplase may improve workflow efficiency for thrombolysis and interfacility transfer, further supporting its broader use in acute ischemic stroke, they concluded.
The study was funded in part by Get With the Guidelines-Stroke, AHA/American Stroke Association. Disclosures for study authors are available with the published article.
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