Comparative Study on Streptokinase, Reteplase and Tenecteplase in the management of ST-Elevated Myocardial Infarction

The aim of this study was to compare the effectiveness and adverse reactions of the three thrombolytic agents viz. Streptokinase, Reteplase and Tenecteplase in the management of ST-Elevated Myocardial Infarction (STEMI).

A prospective study was carried out in STEMI patients to study and compare the effectiveness and adverse reactions of Streptokinase, Reteplase and Tenecteplase in the Department of Cardiology, Durgabai Deshmukh Hospital, a 300 bedded multi-specialty hospital from September 2017 to March 2018.

Among the patients who received Streptokinase, ECG resolution was complete in 57.2% patients, partial in 14.3% patients and nil in 28.5% patients. With respect to adverse reactions, 14.3% patients developed GI bleeding, 85.7% patients developed no complications. In patients who received Reteplase, ECG resolution was complete in 68.8% patients, partial in 12.5% patients and nil in 1.7% patients. With respect to adverse reactions, 6.25% patients developed hypotension and 87.5% patients developed no complications. In patients who received Tenecteplase, ECG resolution was complete in 59.3% patients, partial in 3.7% patients and nil in 37% patients. With respect to adverse reactions, 18.5% patients developed hypotension, 3.8% patients developed tachycardia, 11.1% patients developed GI bleeding and 66.6% patients developed no complications.

From the present study, we have concluded that all the three thrombolytic drugs are similar their effectiveness but Tenecteplase showed few complications compared to other two drugs. Since Streptokinase is economic, the selection of drug can be left to patient's choice by consulting the physicians.