Abstract
Introduction: Tenecteplase (TNK) presents potential advantages in the treatment of acute ischemic stroke (AIS) and is hypothesized to reduce door-to-needle times (DTN). Methods: The Lone Star Stroke (LSS) registry incorporates data from 9 (6 CSC, 3 PSC) Texas hospitals which have and have not switched to TNK, mapping subject data to Get-With-the-Guidelines (GWTG) stroke variables and including patients who received alteplase (ALT) or TNK from October 2019 to March 2023. The dataset is stratified into ALT and TNK groups, generating a univariate table for each measured variable which is further analyzed by descriptive statistics. Polynomial regression models for both ALT and TNK are constructed to explore trends in DTN. Results: Of 621 patients, 459 received ALT and 162 received TNK. The groups had similar mean ages [66.8 (14.4) vs 69.2 (14.7); P=.074], and similar NIHSS scores [11.1 (8.1) vs 11.1 (7.5); P>.977]. The median DTN for ALT of 44 (32-61) mins was similar to 43 (32-61) mins for TNK (P>.05). The proportion of patients meeting DTN cut points was similar, comparing ALT to TNK for <60 minutes (73.9% vs 74.5%); for <45 minutes (50.3% vs 54.3%); and <30 minutes (20.7% vs 21.0%). As shown in Figure 1, regression models indicate no significant temporal trends for ALT (r 2 =.006; P=.08) nor for TNK (r 2 =.015; P=.12). Conclusion: Both TNK and ALT displayed comparable DTN times and exhibited similar temporal trends. Given the timeframe of our cohort, these decreasing trends in DTN times may be influenced by relaxed COVID restrictions and reduced workflow delays. The transition to TNK does not appear to impact workflow nor does it appear to impact stroke core measures. This is likely due to similar inclusion and exclusion criteria, as well as similar administration processes for both medications. The results are encouraging for hospitals seeking to transition to TNK in that these hospitals are unlikely to experience a change in DTN or other stroke core measures during the transition period.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
