Pharmaco-Invasive Strategy With Half-Dose Tenecteplase in Patients With STEMI: Prespecified Pooled Analysis of Patients Aged ≥75 Years in STREAM-1 and 2
Pooled result · Composite of all-cause death, MI, HF and shockResult — go to the resultRelative risk 0.90 95% CI 0.62–1.30Authors' conclusion
Comparable efficacy exists between half- and full-dose tenecteplase pharmaco-invasive treatments with improved safety in patients with ST-segment-elevation myocardial infarction aged ≥75 years.
Study context
- Population
- Patients aged ≥75 years with STEMI in STREAM-1 and STREAM-2
- Participants
- 390 patients
- Comparison
- Half-dose vs full-dose tenecteplase pharmaco-invasive strategy, and half-dose pharmaco-invasive strategy vs primary percutaneous coronary intervention (PCI)
- Full-dosen = 42
- Half-dosen = 205
- Primary PCIn = 143reference
- Outcome
- Composite of:
- All-cause death
- MI
- HF
- Shock
- Follow-up
- 30 days
Pooled result
As reported in the abstract
Relative risk
0.90
95% CI 0.62–1.30
P = 0.567
By group
Half-dosevs Primary PCI
RR 0.90 (95% CI 0.62–1.30); P = 0.567
Further pooled results
| Outcome | Full-dose | Half-dose | Primary PCI | P value |
|---|---|---|---|---|
| ≥50% ST-segment resolution post-tenecteplase | 62.6% | 63.2% | — not stated in the abstract | |
| ≥50% ST-segment resolution post-angiographyHalf-dose vs Primary PCI | — not stated in the abstract | 77.9% | 72.4% | P = 0.277 |
— not stated in the abstract
≥50% ST-segment resolution post-tenecteplase
- Similar proportions, half-dose vs full-dose
Safety
| Outcome | Full-dose | Half-dose |
|---|---|---|
| Intracranial hemorrhage | 7.1% | 0% |
Intracranial hemorrhage
- No intracranial hemorrhage in half-dose vs primary PCI comparison
Original publication
Pharmaco-Invasive Strategy With Half-Dose Tenecteplase in Patients With STEMI: Prespecified Pooled Analysis of Patients Aged ≥75 Years in STREAM-1 and 2. Circ Cardiovasc Interv. Published 17 December 2024. doi:10.
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