Abstract Details

Title Effectiveness of Tenecteplase Versus Alteplase in Acute Ischemic Stroke Selected Subgroups of a Real-world Data Set

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-005

Objective We studied the comparative effectiveness of Acute Ischemic Stroke (AIS) thrombolysis with Tenecteplase (TNK) versus alteplase (tPA) to understand the impact in understudied AIS subgroups.

Background

TNK is increasingly utilized as an alternative AIS thrombolytic to tPA. Although many larger AIS trials have demonstrated the non-inferiority of TNK, real world data for many less common subgroups islacking.

Design/Methods We conducted a retrospective cohort analysis of AIS patients treated with thrombolysis within our health system. We utilized the Get With the Guidelines (GWTG) database to obtain patient demographic data. Additional variables and key outcomes (functional and radiographic) were abstracted independently from the electronic medical record. The primary outcome was the modified Rankin Scale (mRS) at 90 days assessed via ordinal logistic regression. Subgroups included Age (<60, 61-80, >80), location of vessel occlusion (Large or Medium vessel), thrombolysis in the extended time window (beyond 4.5 hours), treatment via telestroke, and thrombectomy.

Results 500 consecutive AIS patients with complete outcome data were included ( Age: (Mean(SD)) 70 (16.05), 47.3% female, 71% TNK, 22% thrombectomy). In the adjusted ordinal logistic regression analysis, the TNK group had 1.00 odds of a worse mRS score (95% CI 0.57-1.74). Subgroup regression analysis demonstrated no heterogeneity in treatment effect.

Conclusions Our real world analysis revealed no difference in outcomes between TNK or tPA.We also did not find any differences in currently understudied subgroups. Our analysis may further support universal adoption of TNK for AIS thrombolysis.

Authors/Disclosures
Pramit Jagtap PRESENTER	Mr. Jagtap has nothing to disclose.
Luis G. Silva, MD	Dr. Silva has nothing to disclose.
Shayan Khan (university of minnesota)	No disclosure on file
Solmaz Ramezani Hashtjin, MD	Dr. Ramezani Hashtjin has nothing to disclose.
Karen Stalin (University of Minnesota)	No disclosure on file
Saketh Annam, MBBS	Dr. Annam has nothing to disclose.
David Schneck	No disclosure on file
Mark Fiecas	No disclosure on file
Annette Xenopoulos-Oddsson (University of Minnesota, Masonic Institute for the Developing Brain)	Annette Xenopoulos-Oddsson has nothing to disclose.
Cynthia Zheng	Ms. Zheng has nothing to disclose.
Savannah Novy, MD	Ms. Novy has nothing to disclose.
Salman Ikramuddin, MD (Duke University Department of Neurology)	Dr. Ikramuddin has nothing to disclose.
Abbey Staugaitis	Abbey Staugaitis has nothing to disclose.
Christopher Streib, MD (Department of Neurology)	Dr. Streib has nothing to disclose.

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