Better chance of survival for reteplase patients?
Early indicators are better in reteplase group
Reteplase-treated patients seem to have an increased chance of survival. Administration of r-PA (Penzberg, Germany-based Boehringer Mannheim’s Retavase) appears to be have promising, noninvasive early prognostic abilities in addition to its therapeutic attributes.Early resolution of ST segment elevation following an acute myocardial infarction (AMI) is a strong predictor of positive outcome, according to findings of the INJECT (International Joint Efficacy Comparison of Thrombolytics) trial.1 The trial, which involved more than 6,000 AMI patients in nine European countries, showed that administration of the thrombolytic agent reteplase resulted in increased incidence of early resolution of ST segment evaluation.
A sub-study focusing on 1,398 German patients involved in the INJECT study assessed the results of reteplase administration in some patients and streptokinase in others. The extent of ST segment elevation resolution was greater in the reteplase group.
Reteplase is the only available thrombolytic that can be administered in two simple double-bolus doses. Among its advantages over other thrombolytics:
• complete perfusion and patency in significantly more patients at 60 minutes compared to accelerated infusion regimen with alteplase;
• effective in reducing mortality;
• documented safety profile;
• simple, precise administration;
• proven salvage of ventricular function.2
References
1. Randomized, double-blind comparison of reteplase double-bolus administration with streptokinase in acute myocardial infarction (INJECT). Trial to investigate equivalence. Lancet 1995; 346:329-336.
2. Bode C, Smalling RW, Berg G, et al. Randomized comparison of coronary thrombolysis achieved with double-bolus reteplase and front-loaded, accelerated alteplase in patients with acute myocardial infarction: The RAPID II (Reteplase and Alteplase Patency Investigation During Myocardial Infarction). Circulation 1996; 94:891-898.
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