Abstract Details

Title Comparing Tenecteplase and Alteplase in Acute Ischemic Stroke Treatment: A Comprehensive Outcome Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-021

Objective Comparing Tenecteplase and Alteplase in Acute Ischemic Stroke Treatment throughout the state of Texas.

Background Tenecteplase (TNK) is emerging as a replacement for alteplase (ALT) to treat acute ischemic treatment (AIS).

Design/Methods The Lone Star Stroke registry combines data from 9 CSC and 4 PSC Texas hospitals mapped to GWTG variables. Cases include AIS patients who received ALT or TNK (10/1/19 – 3/31/23). Chi-square models with odds ratio (95% CI) were developed to explore primary and secondary outcomes

Results The 1140 patients who received ALT (476) or TNK (664) had similar median NIHSS scores [ALT = 9 (4-16), TNK = 8 (4-14); mean age [ALT = 66.7 (14.3), TNK = 67.8 (15.1); P= .20]; and proportion of males [ALT = 56.3%, TNK = 58.7%; P= .43]. The TNK cohort were more likely white (P<.001), and non-Hispanic (P<.001). EVT treatment were similar by group (ALT = 23.8%, TNK = 23.2%). Reperfusion (≥TICI 2B) was similar by group (ALT = 90.5%, TNK = 91.7%; P=0.37). However, odds of a discharge status (mRS < 3) were lower for ALT than TNK [34.7% vs 44.9%; 0.5 (0.38-0.68)]; similarly, the odds of having an independent ambulation status were lower for ALT than TNK [ 47.8% vs 54.9%; 0.75 (0.56 -0.9)]. Treatment related complications within 36 hours (including life threatening sICH and other serious events) was similar for those not undergoing EVT [ALT = 6 (1.3%), and TNK = 15 (2.3%), OR 1.81 (0.7-4.7)]; and for patients who underwent EVT [ALT = 3 (2.9%), and TNK = 6 (5.3%), OR 1.85 (0.5-7.6)].

Conclusions In this real-world Texas stroke cohort, TNK has a comparable safety profile with similar or improved functional outcomes when compared with ALT. Because centers transitioned to TNK during the study, these findings support hospitals transitioning to TNK without requiring major workflow modifications, ultimately leading to improved treatment outcomes.

Authors/Disclosures
Sujani Bandela, MD PRESENTER	Dr. Bandela has nothing to disclose.
Gretchel Gealogo Brown (UT Health San Antonio)	Gretchel Gealogo Brown has nothing to disclose.
Sidarrth Prasad, MBBS (University of Texas, Southwestern Medical Center)	Sidarrth Prasad has nothing to disclose.
Shripal Gunna (University of Texas Southwestern)	No disclosure on file
DaiWai Olson	The institution of DaiWai Olson has received research support from Neuroptics. The institution of DaiWai Olson has received research support from Chiesi.
Lee Birnbaum, MD	Dr. Birnbaum has nothing to disclose.
Nathaniel Rodriguez	No disclosure on file
Suzanne Stone (University of Texas Southwestern)	Suzanne Stone has nothing to disclose.
Jane Anderson (Veterans Health Administration)	The institution of Jane Anderson has received research support from UT Systems.
Sean I. Savitz, MD	Dr. Savitz has nothing to disclose.
Salvador Cruz-Flores, MD, FAAN (Paul L. Foster School of Medicine Texas Tech University Health Sciences Center)	The institution of Dr. Cruz-Flores has received research support from University of Texas System.
Steven Warach, MD, PhD (Dell Medical School, The University of Texas at Austin)	Dr. Warach has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. The institution of Dr. Warach has received research support from State of Texas. Dr. Warach has received publishing royalties from a publication relating to health care.
Charlotte Rhodes (UT Health San Antonio)	No disclosure on file
Mark P. Goldberg, MD (UT Health San Antonio)	The institution of Dr. Goldberg has received research support from NIH. The institution of Dr. Goldberg has received research support from State of Texas .

��ɫ��

��ɫ��