COMPARISON OF RETEPLASE DOUBLE-BOLUS ADMINISTRATION WITH STREPTOKINASE IN ACUTE MYOCARDIAL INFARCTION

Authors

  • Mirvete Rama "Mother Theresa" Hospital Center Tirana, Albania
  • Mirela MiraÇi Medicine University
  • Ela Petrela Medicine University
  • Ledjan Malaj Medicine University

Keywords:

Cardiovascular disease, Acute myocardial infarction, Thrombolytics, Tissue plasminogen activator (t-PA), Reteplase, Streptokinase, Cost-effectiveness, Lek= Albanian money

Abstract

Objective: To evaluate the thrombolytic treatment in acute myocardial infarction (AMI) and to compare the costs and the effectiveness of Reteplase double-bolus vs Streptokinase in our clinic, to compare this data with other studies.

Methods: Two thrombolytic treatments were compared; Reteplase and Streptokinase in AMI by following the patients during hospital stay and at certain periods of time of 6 months, 12 months and 24 months. Differences between the two groups (streptokinase and reteplase) for discrete variables were performed by the Student test for two samples and Hi-square test. Data analysis was performed with SPSS statistical package, version 18

Results: The analysis showed no significant differences between the treatments regarding the effectiveness. After 6 months, 12 months and 24 months observation, the survival rate was 96.4% for reteplase group and 96.9% for streptokinase group. The mean age was 64.29 years for reteplase group and 56.03 years for streptokinase group (p=0.001). Hospitalization in reteplase group was at an average of 13.04days, and in streptokinase group was at an average of 17.79days (p=0.01)

Cost in each respective group was 90184.90 Lek (646€) and 54148.63 Lek (388€). The difference is 36036.27 Lek or 258€ (p=0.001).

Conclusion: Both thrombolytics (reteplase and streptokinase) have similar effectiveness in treatment of Acute Myocardial Infarction. Reteplase is an effective drug in the treatment of clinically Acute Myocardial Infarction, but the cost of reteplase is higher than streptokinase. It is safe, easily applied and it will be a useful addition to the valid list of thrombolytic drugs.

 

Downloads

Download data is not yet available.

References

Fuster V, Narula J, Kelly BB. Promoting global cardiovascular and cerebrovascular health. Mt Sinai J Med 2012;79(6):625-31.

Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, et al. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the american college of cardiology/american heart association task force on practice guidelines (Committee on the management of patients with unstable angina). J Am Coll Cardiol 2000;36(3):970-1062.

Armstrong PW, Collen D. Fibrinolysis for acute myocardial infarction: current status and new horizons for pharmacological reperfusion, part 1. Circulation 2001;103(23):2862-6.

White H, Van de Werf F. Thrombolysis for acute myocardial infarction. Circulation 1998;97:1632–46.

F Rovelli, C DE Vita, GA Feruglio, A Lotto, A Selvini, G Tognoni. Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Gruppo Italiano per lo Studio della Streptochinasi nell' Infarto Miocardico (GISSI). Lancet 1986;327(8478):397–402.

Llevadot J, Giugliano PR, Antman EM. Bolus fibrinolytic therapy in acute myocardial infarction. JAMA 2001;286:442–9.

Hampton JR, Schroder R, Wilcox RG, Skene AM, Meyer-Sabellek W, Heikkila J, et al. Randomised, double-blind comparison of reteplase double-bolus administration with streptokinase in acute myocardial infarction (INJECT): trial to investigate equivalence. International joint efficacy comparison of thrombolytics. Lancet 1995;346:329–36.

Dundar Y, Hill R, Dickson R, Walley T. Comparative efficacy of thrombolytics in acute myocardial infarction: a systematic review. Q J Med 2003;96:103–13.

Smalling RW, Bode C, Kalbfleisch J, Sen S, Limbourg P, Forycki F, et al. More rapid, complete, and stable coronary thrombolysis with bolus administration of reteplase compared with alteplase infusion in acute myocardial infarction: RAPID Investigators. Circulation 1995;91:2725–32.

Wilcox RG, Clinical trials in thrombolytic therapy: what do they tell us? INJECT 6-month outcomes data. Am J Cardiol 1996;78(12A):20-3.

Topol EJ, Ohman EM, Armstrong PW, Wilcox R, Skene AM, Aylward P, et al. Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction: results from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III Trial. Circulation 2000;102(15):1761-5.

Bode C, Smalling RW, Berg G, Burnett C, Lorch G, Kalbfleisch JM, et al. Randomized comparison of coronary thrombolysis achieved with double-bolus reteplase (recombinant plasminogen activator) and front-loaded, accelerated alteplase (recombinant tissue plasminogen activator) in patients with acute myocardial infarction: the RAPID II Investigators. Circulation 1996;94:891–8.

Krumholz HM, Pasternak RC, Weinstein MC, Friesinger GC, Ridker PM. Cost effectiveness of thrombolytic therapy with streptokinase in elderly patients with suspected. Acute myocardial infarction. N Engl J Med 1992;327:7-13.

Goel V, Naylor CD. Potential cost effectiveness of intravenous tissue plasminogen activator versus streptokinase for acute myocardial infarction. Canadian J Cardiol 1992;8(1):31-8.

Dundar Y, Hill R, Dickson R, Walley T. Comparative efficacy of thrombolytics in acute myocardial infarction: a systematic review. Q J Med 2003;96(2):103-13.

Lundergan CF, Ross AM, McCarthy WF, Reiner JS, Boyle D, Fink C, et al. Predictors of left ventricular function after acute myocardial infarction: effects of time to treatment, patency, and body mass index: the GUSTO-I angiographic experience. Am Heart J 2001;142(1):43-50.

Moser M, Kohler B, Schmittner M, Bode C. Recombinant plasminogen activators: a comparative review of the clinical pharmacology and therapeutic use of alteplase and reteplase. BioDrugs 1998;9(6):455-63.

Weaver WD. The role of thrombolytic drugs in the management of myocardial infarction. Comparative clinical trials. Eur Heart J 1996;17 Suppl F:9-15.

Published

01-06-2015

How to Cite

Rama, M., M. MiraÇi, E. Petrela, and L. Malaj. “COMPARISON OF RETEPLASE DOUBLE-BOLUS ADMINISTRATION WITH STREPTOKINASE IN ACUTE MYOCARDIAL INFARCTION”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 7, no. 6, June 2015, pp. 180-3, https://www.innovareacademics.in/journals/index.php/ijpps/article/view/5545.

Issue

Section

Original Article(s)