Expanding role of tenecteplase in patients with cardiovascular diseases.

摘要

Tenecteplase (INK) is the latest and probably the hottest kid on the block among the thrombolytics. One has come a long way since the earliest days of streptokinase being used as a thrombolytic agent in acute myocardial infarction(AMI) over two decades ago. TNK is a variant of the native tissue-type plasminogen activator (tPA) molecule that has 14-fold greater fibrin specificity than alteplase, a longer half-life, slower plasma clearance, and 80-fold greater resistance to inhibition by plasminogen activator inhibitor type 1. Its half-life of approximately 18 minutes allows single-bolus administration. In comparative clinical trials, TNK was found to have equivalent efficacy to recombinant tPA (alteplase). The rate of intracranial hemorrhage with TNK was similar to that with alteplase and TNK was associated with fewer non-cerebral complications and less need for blood transfusions. These refinements in the thrombolytic agents have gone hand in hand with the expanding (sometimes even unusual) indications for their usage well beyond the classical indications of AMI. This article aims to review some such expanding and unusual indications wherein TNK has been used.