COMPARISON OF RETEPLASE DOUBLE-BOLUS ADMINISTRATION WITH STREPTOKINASE IN ACUTE MYOCARDIAL INFARCTION
Keywords:Cardiovascular disease, Acute myocardial infarction, Thrombolytics, Tissue plasminogen activator (t-PA), Reteplase, Streptokinase, Cost-effectiveness, Lek= Albanian money
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 (646â‚¬) and 54148.63 Lek (388â‚¬). The difference is 36036.27 Lek or 258â‚¬ (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.
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