Pharmaco-invasive strategy including Metalyse comparable to primary PCI for STEMI patients

New data presented at the American College of Cardiology 62nd Annual Scientific Sessions and Expo demonstrate that patients with ST elevation acute myocardial infarction (STEMI), who cannot undergo primary percutaneous intervention (PCI) in a catheterization lab within 60 minutes of first medical contact, have similar clinical outcomes from early fibrinolysis with Metalyse (tenecteplase, TNK-tPA) followed by timely angiography (pharmaco-invasive strategy), compared to primary PCI.

Metalyse, a single-bolus thrombolytic drug has been marketed by German family-owned drug major Boehringer Ingelheim since around 2001, and is sold by partner Genentech in the USA as TNKase.

"A significant number of patients who suffer from an acute heart attack don’t reach a cath lab within the recommended timeframe," said STREAM principal investigator Professor F Van de Werf of the University Hospital Gasthuisberg, Leuven, Belgium. "Prehospital fibrinolysis with timely coronary angiography, although associated with a small risk of intracranial bleeding, resulted in effective reperfusion in early presenting STEMI patients who cannot undergo primary PCI within one hour of first medical contact," he noted.