| Review of tenecteplase (TNKase) in the treatment of acute myocardial infarction. | |
| | |
MedLine Citation:
|
PMID: 19436656 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
TNKase is a genetically engineered variant of the alteplase molecule. Three different mutations result in an increase of the plasma half-life, of the resistance to plasminogen-activator inhibitor 1 and of the thrombolytic potency against platelet-rich thrombi. Among available agents in clinical practice, TNKase is the most fibrin-specific molecule and can be delivered as a single bolus intravenous injection. Several large-scale clinical trials have enrolled more than 27,000 patients with acute myocardial infarction, making the use of this drug truly evidence-based. TNKase is equivalent to front-loaded alteplase in terms of mortality and is the only bolus thrombolytic drug for which this equivalence has been formally demonstrated. TNKase appears more potent than alteplase when symptoms duration lasts more than 4 hours. Also, TNKase significantly reduces the rate of major bleeds and the need for blood transfusions. The efficacy of TNKase may be further improved by enoxaparin substitution for unfractionated heparin, provided that enoxaparin dose adjustment is made for patients more than 75 years old. Hitherto, the small available randomized studies and international clinical registries suggest that pre-hospital TNKase is as effective as primary angioplasty, thus laying the foundations for a new fibrinolytic, TNKase-based strategy as the backbone of reperfusion in acute myocardial infarction. |
| | |
Authors:
|
Giovanni Melandri; Fabio Vagnarelli; Daniela Calabrese; Franco Semprini; Samuele Nanni; Angelo Branzi |
Related Documents
:
|
12792256 - Treatment seeking for acute myocardial infarction symptoms: differences in delay across... 10522716 - Six-month assessment of a phase i trial of angiogenic gene therapy for the treatment of... 3315576 - Achievement of coronary artery patency by use of anisoylated plasminogen streptokinase ... 15989666 - Alteplase. 7901536 - Failure of new biochemical markers to exclude acute myocardial infarction at admission. 20491606 - Angiotensin receptor blocker-based therapy and cardiovascular events in hypertensive pa... |
Publication Detail:
|
Type: Journal Article; Review Date: 2009-04-08 |
Journal Detail:
|
Title: Vascular health and risk management Volume: 5 ISSN: 1178-2048 ISO Abbreviation: - Publication Date: 2009 |
Date Detail:
|
Created Date: 2009-05-13 Completed Date: 2009-06-19 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 101273479 Medline TA: Vasc Health Risk Manag Country: New Zealand |
Other Details:
|
Languages: eng Pagination: 249-56 Citation Subset: IM |
Affiliation:
|
Dipartimento Cardiovascolare, Università di Bologna, Italy. giovanni.melandri@aosp.bo.it |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angioplasty, Transluminal, Percutaneous Coronary Blood Transfusion Drug Administration Schedule Drug Therapy, Combination Emergency Medical Services Fibrinolytic Agents / administration & dosage, adverse effects, therapeutic use* Hemorrhage / chemically induced, prevention & control Humans Injections, Intravenous Myocardial Infarction / drug therapy* Thrombolytic Therapy* Tissue Plasminogen Activator / administration & dosage, adverse effects, therapeutic use* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Fibrinolytic Agents; 0/tenecteplase; EC 3.4.21.68/Tissue Plasminogen Activator |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Effect of angiotensin receptor blockade on endothelial function: focus on olmesartan medoxomil.
Next Document: Efficacy and safety of rosuvastatin in the management of dyslipidemia.