To compare differences in treatment workflow time intervals between tenecteplase-treated and alteplase-treated patients with ischemic stroke.
Approach:
Study Design: Registry-based cohort study using data from the Get With The Guidelines–Stroke database.
Patient Inclusion Criteria: Patients admitted between July 1, 2020, and June 30, 2022, with a principal discharge diagnosis of ischemic stroke treated with intravenous thrombolytics.
Data Collection: Data abstracted from electronic medical records, including time intervals from hospital arrival to treatment.
Hospital Categorization: Hospitals categorized based on tenecteplase utilization: high, moderate, and nonutilizers/low utilizers.
Key Findings:
Tenecteplase offers shorter preparation and administration times compared to alteplase.
Tenecteplase may reduce door-to-needle time (DTN) and door-in-door-out time (DIDO).
The study analyzed treatment workflow efficiency during the early adoption of tenecteplase in the US.
Interpretation:
The findings suggest that tenecteplase may enhance treatment efficiency for acute ischemic stroke compared to alteplase.
Limitations:
Data were collected primarily for quality improvement, which may affect the comprehensiveness of the dataset.
Exclusion of patients treated at hospitals with fewer than 5 thrombolysis cases may limit generalizability.
Conclusion:
The study highlights the potential advantages of tenecteplase in improving treatment workflow for ischemic stroke.
by Steven J. Warach, Jeremy M. Weber, Brooke Alhanti, Steven R. Messé, Lee H. Schwamm, Gregg C. Fonarow, Kevin N. Sheth, Eric E. Smith, Michael T. Mullen, Gisele Sampaio Silva, Brian Mac Grory, Ying Xian, Jeffrey L. Saver
