A Cross-Sectional Study of Comparative Coronary Angiographic Profile of Successful and Failed Thrombolysis with Tenecteplase Conducted at Osmania General Hospital, Hyderabad

BACKGROUND Acute Myocardial Infarction (AMI) can lead to death, and thrombolytic therapy (TLT) is a common treatment protocol. However, thrombolysis is not always successful, and there are numerous contributing factors. We wanted to compare and contrast the coronary angiographic profile of patients with successful and failed thrombolysis with tenecteplase. METHODS Cases of AMI receiving tenecteplase were categorized as successful and failed thrombolysis groups. Fifty patients in each group were compared for various characteristics such as age, sex, risk factors, time to thrombolysis, LV function, number of coronary vessels involved, angiographic lesion characteristics, thrombolysis in myocardial infarction (TIMI) flow, and to look for features that may predispose to thrombolysis failure. To determine the association between variables, chi-square test and logistic regression were used. RESULTS The mean age in the successful & failed thrombolysis group was 50.72 years and 53.48 years. Gender, diabetes, hypertension, smoking, alcohol, type of MI were not statistically significant for failed thrombolysis. All patients with window period < 3 hrs had successful thrombolysis and most patients with window period > 6 hrs had failed thrombolysis (87.2 %). (P < 0.001). Most patients (75.9 %) with Type A lesions had successful thrombolysis and patients with Type B & C lesions (88.1 %) had failed thrombolysis. (P < 0.001). CONCLUSIONS In patients with longer window periods, failed thrombolysis was more common and was associated with complex coronary lesion morphology. This study reemphasizes the value of early thrombolysis for effective reperfusion and clinical outcome improvement. KEYWORDS Failed Thrombolysis, Tenecteplase, Angiographic Profile