Safety and efficacy of streptokinase, tenecteplase, and reteplase in patients diagnosed with ST-elevation myocardial infarction: A comparative study

Abstract

Objective: Our primary objective was to compare the efficacy of streptokinase (SK), tenecteplase, and reteplase by studying patients' electrocardiogram Electrocardiogram(ECG) pre and post thrombolysis. The secondary objectives were to assess chest pain relief using Numerical Pain Rating Scale score and also to compare the side effects (bleeding, hypotension, and anaphylaxis) of three drugs. Materials and Methods: This study is a multicentric, prospective, randomized, comparative study. This study was conducted on 150 patients of ST-elevation myocardial infarction admitted in the wards/ICCU- Intensive Coronary Care Unit, Department of Cardiology, Mahatma Gandhi Memorial Hospital and Rohini Superspeciality Hospital. They were selectively divided into three groups. Group A consisted of patients who received SK (50), Group B who received tenecteplase (50), and Group C who received reteplase (50). The study period was 6 months. The follow-up was done in all the patients during their inhospital stay. Results: Post thrombolysis, reteplase, tenecteplase, and SK led to mean ST-Segment reduction of 64.9 ± 19.77, 52.43 ± 34.57, and 46.97 ± 33.09, respectively. The comparison between the three drugs revealed a significant difference (P = 0.0103). Conclusion: This study concluded that reteplase is most efficacious in the resolution of ST-elevation and also safer than other thrombolytics used.

Keywords

• reteplase
• st-elevation myocardial infarction
• streptokinase
• tenecteplase
• thrombolytics