Valvular & structural heart disease
Tenecteplase vs Alteplase in Mechanical Prosthetic Heart Valve Thrombosis: The TENET Randomized Clinical Trial
Primary result · Complete thrombolytic success (primary efficacy end point)Result — go to the resultRelative risk 1.18 95% CI 1.03–1.39Authors' conclusion
Tenecteplase may be a safe and effective alternative to alteplase in patients presenting with obstructive PVT.
Study context
- Population
- Consecutive adults with obstructive prosthetic valve thrombosis (PVT) of a mechanical prosthetic valve, single tertiary centre in India, October 2022 to August 2024
- Participants
- 83 adults
- Comparison
- Tenecteplase vs alteplase
- Tenecteplasen = 40
- Alteplasen = 43reference
- Primary endpoint
- Complete thrombolytic success and incidence of major complications
Methodological detailsopen-label, parallel-group, non-inferiority, single-centre
- Open-label
- Parallel-group
- Non-inferiority
- Single-centre
Primary result
As reported in the abstract
Complete thrombolytic success (primary efficacy end point)
Relative risk
1.18
95% CI 1.03–1.39
P = 0.02 for non-inferiority
Events by treatment group
Tenecteplase vs Alteplase
RR 1.18 (95% CI 1.03–1.39); P for non-inferiority = 0.02
Further findings
Duration of hospital stay
P < 0.001
Complete success with first administered dose
- Higher with tenecteplase
Safety
Major and minor adverse events
- Similar in the two groups
Original publication
Tenecteplase vs Alteplase in Mechanical Prosthetic Heart Valve Thrombosis: The TENET Randomized Clinical Trial. JAMA Cardiol. Published 1 January 2026. doi:10.
Summarised from the published abstract; every number is checked against it