Title of article :
Tenecteplase Versus Reteplase in Acute Myocardial Infarction: A Network Meta-Analysis of Randomized Clinical Trials
Author/Authors :
Zia Behbahani, Majid Student Research Committee - Shiraz University of Medical Sciences, Shiraz, Iran , Niknahad, Hossein Department of Pharmacology and Toxicology - Faculty of Pharmacy - Shiraz University of Medical Sciences, Shiraz, Iran , Kojuri, Javad Quality Improvement in Clinical Teaching Research Center - Shiraz Education Center - Faculty of Medical Education, -Shiraz University of Medical Sciences, Shiraz, Iran , Salesi, Mahmood Chemical Injuries Research Center - Systems Biology and Poisonins Institute - Baqiyatallah University of Medical Science, Tehran, Iran , Jafari, Mojtaba Health Human Resources Research Center and Department of Health Economic - School of Management and Medical Informatics - Shiraz University of Medical Sciences, Shiraz, Iran , Keshavarz, Khosro Health Human Resources Research Center and Department of Health Economic - School of Management and Medical Informatics - Shiraz University of Medical Sciences, Shiraz, Iran
Abstract :
Acute myocardial infarction (AMI) is the leading cause of death throughout the world. One
of the standard approaches to treatment of AMI is fibrinolysis. The study was conducted to
evaluate the clinical efficacy of tenecteplase versus reteplase through network meta-analysis
for AMI. Randomized trials were comprehensively searched in PubMed, Scopus, Cochrane
library, and Web of Science using appropriate strategies. Quality assessment was done for
the papers. The primary and secondary end-points were mortality, TIMI grade 3 flow at 90
min, death or non-fatal stroke, infarction, total stroke and major bleeding. Odds ratios (OR)
were computed (95% confidence intervals). After screening 27325 records, eight articles were
included with total patients of 49875 to the meta-analysis. Indirect comparison of tenecteplase
vs. reteplase showed no significant differences in the risk of mortality (OR = 0.98, p > 0.05),
TIMI grade 3 flow at 90 min (OR = 0.77, p > 0.05), death or non-fatal stroke (OR = 1.04, p >
0.05), infarction (OR = 1.11, p > 0.05), total stroke (OR = 2.71, p > 0.05), and major bleeding
(OR = 0.81, p > 0.05) (all p > 0.05). Indirect comparison suggests similar efficacy and safety
of tenecteplase and reteplase. Hence, the use of each one of the two medicines depends on
price, facility, and accessibility of the medicine.
Keywords :
Clinical efficacy , Network meta-analysis , Acute myocardial infarction , Alteplase , Tenecteplase , Reteplase
Journal title :
Astroparticle Physics
