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Tenecteplase in current clinical practice


Authors: S. Janoušek
Authors‘ workplace: Interní kardiologická klinika, FN Brno‑Bohunice
Published in: Kardiol Rev Int Med 2010, 12(1): 46-53

Overview

Tenecteplase is the third generation thrombolytic agent produced by genetic engineering by mutation of the classical Plasminogen Activator (tPA) and with the main aim to increase resistence against natural Plasminogen Activator Inhibitor (PAI‑ l) and prolongation of its biological halftime. Tenecteplase is fibrin‑specific and, as its substantial advantage, its halftime allows IV administration by single bolus. Recently, it has become the trombolytic agent of the first choice in the developed countries for the treatment of acute myocardial infarction (AMI) with ST‑segment elevation (STEMI) and its properties predestine it to be an ideal drug for pre‑hospital treatment. At present, a large international multicentric study STREAM is under way to evaluate its benefits in the early stage of AIM over direct coronary angioplasty. It has been used with favourable results in other acute clinical indications, such as a pulmonary embolism and arterial and venous closure. However, no randomized trials have been conducted so far in these indications. The possibility of its application in acute ischemic stroke is being verified, the small randomized studies performed so far have provided favourable results.

Keys words:
tenecteplase – acute myocardial infarction – pre‑hospital treatment – acute pulmonary embolism –

acute vessel closure – acute ischemic stroke


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