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Comparing outcomes of
IV medications in
stroke patients

Outcomes associated with IV tenecteplase and IV alteplase for acute ischemic stroke with or without thrombectomy in real-world settings in the United States


  • Research Question: What is the effect of intravenous (IV) tenecteplase (TNK) medication compared with IV alteplase medication on occurrence of 1) non-routine discharge or death, and 2) intracranial hemorrhage in acute ischemic stroke patients stratified by use of thrombectomy and after adjusting for potential confounders?
  • Research Findings: Among 30,643 acute ischemic stroke patients, 96.2% received IV alteplase treatment, and 3.8% received IV TNK treatment. The proportion of patients who received thrombectomy and those who had intracranial hemorrhage (brain bleeding) was higher among patients treated with IV TNK. There was no difference in the rate of non-routine discharge or death between patients treated with IV TNK and those treated with IV alteplase in the multivariate analyses.
  • Research Meaning: In an analysis of real-world data, intravenous (IV) tenecteplase (TNK) was associated with higher rates of intracranial hemorrhage compared with IV alteplase in patients with acute ischemic stroke.