acute myocardial infarction | versus No demonstrated result for efficacy inferior to primary intervention in terms of Short-term death in ASSENT-4 PCI (Van de Werf), 2006 inferior to primary intervention in terms of Short-term non-fatal reinfarction in ASSENT-4 PCI (Van de Werf), 2006 inferior to primary intervention in terms of Short-term urgent target vessel revascularisation in ASSENT-4 PCI (Van de Werf), 2006 inferior to primary intervention in terms of Initial TIMI 3 flow in ASSENT-4 PCI (Van de Werf), 2006 tenecteplase inferior to primary intervention in terms of Initial TIMI 3 flow in GRACIA (Fernandez-Aviles,), 2004 | 3 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
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ASSENT-4 PCI (Van de Werf), 2006 | vs primary intervention | | Short-term death 1.58 [1.02; 2.43] Short-term non-fatal reinfarction 1.82 [1.12; 2.97] Short-term urgent target vessel revascularisation 4.56 [2.13; 9.75] Initial TIMI 3 flow 2.90 [2.42; 3.46] | Short-term major bleeding in patients treated 1.26 [0.82; 1.92] Final TIMI 3 flow 0.99 [0.95; 1.02] | GRACIA (Fernandez-Aviles,), 2004 | tenecteplase vs primary intervention | | Initial TIMI 3 flow 4.90 [2.90; 8.28] | Short-term death 0.62 [0.15; 2.54] Short-term major bleeding in patients treated 0.35 [0.04; 3.27] Short-term non-fatal reinfarction 1.04 [0.07; 16.39] Short-term urgent target vessel revascularisation 1.04 [0.07; 16.39] Final TIMI 3 flow 1.04 [0.92; 1.16] | | Eptifibatide + tenecteplase vs primary intervention | | | |
Trial | Treatments | Patients | Method |
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ASSENT-4 PCI (Van de Werf), 2006 | facilated PCI with tenecplase bodyweight-adjusted intravenous bolus: 30 mg of drug if bodyweight <60 kg, 35 mg if60–69 kg, 40 mg if 70–79 kg, 45 mg if 80–89 kg, and 50 mg if >=90 kg (n=829) vs. primary intervention (n=838) | symptom duration <6 h | Sample size: 829/838 Primary endpoint: FU duration: 30-day | GRACIA (Fernandez-Aviles,), 2004 | facilated PCI with bodyweight-adjusted intravenous tenecteplase bolus: 30 mg of drug if bodyweight <60 kg, 35 mg if60–69 kg, 40 mg if 70–79 kg, 45 mg if 80–89 kg, and 50 mg if >=90 kg and Abciximab; 0·25 mg/kg intravenousbolus, 0·125 g/kg per min infusi (n=104) vs. primary intervention (n=108) | symptom duration <12h | Sample size: 104/108 Primary endpoint: FU duration: 30-day | ADVANCE-MI, 2005 | facilated PCI with Eptifibatide, 180 µg/kg intravenous double bolus, 2·0 µg/kg per min infusion and tenecteplase 0·25 mg/kg (intravenous bolus) (n=69) vs. (n=77) | symptom duration <4h | Sample size: 69/77 Primary endpoint: FU duration: 30 days |
|
acute myocardial infarction | versus other fibrinolytic No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
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ASSENT-2, 1999 | tenecteplase vs accelerated t-PA | Hémorragies majeures précoces 0.78 [0.69; 0.89] | | Mortalité précoce 1.01 [0.89; 1.13] AVC précoce 1.07 [0.86; 1.35] |
Trial | Treatments | Patients | Method |
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ASSENT-2, 1999 | Tenecteplase en IV bolus (dose en fonction du poids: 30 mg si < 60 kg; 35 mg si poids entre 60 et 69.9 kg; 40 mg pour les 80-89.9 kg; 50 mg si > ou = 90 kg (n=8461) vs. Alteplase en IV, bolus de 15 mg, puis 0.75 mg/kg (sans dépasser 50 mg) en 30 min puis 0.50 mg/kg (sans dépasser 35 mg) en 60 min (n=8488) | patients with acute myocardial infarction of less than 6 h duration | double blind Parallel groups Sample size: 8461/8488 Primary endpoint: Mortality 30-day FU duration: 30d |
|
cardiac arrest | versus placebo No demonstrated result for efficacy | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
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TROICA, 2008 | tenecteplase vs placebo | | | death 0.87 [0.66; 1.14] Ischemic stroke 0.87 [0.66; 1.14] Symptomatic intracranial hemorrhage 0.87 [0.66; 1.14] Survival to hospital discharge 0.87 [0.66; 1.14] Return of spontaneous circulation 0.87 [0.66; 1.14] failure to return of spontaneous circulation 1.03 [0.97; 1.08] death before hospital discharge 1.03 [0.97; 1.08] | TICA, 2004 | tenecteplase vs placebo | | | death 0.95 [0.78; 1.17] |
Trial | Treatments | Patients | Method |
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TROICA, 2008 | tenecteplase (dose according to estimated
body weight) (n=525) vs. placebo (n=525) | adults with witnessed out-of-hospital cardiac arrest of presumed cardiac origin and with initiation of basic or advanced life support within 10 minutes after collapse | doubel blind Parallel groups Sample size: 525/525 Primary endpoint: 30-day survival FU duration: 30 days | TICA, 2004 | tenecteplase 50 mg (n=19) vs. placebo (n=16) | All victims of out of hospital cardiac arrest | double blind Parallel groups Sample size: 19/16 Primary endpoint: return of spontaneous circulation FU duration: |
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