A Systematic Review and Meta-Analysis of the Safety and Effectiveness of Tenecteplase Versus Alteplase in Treatment of Patients with ST-Elevation Myocardial Infarction

thrombolytic therapy, an appropriate treatment option , if primary angioplasty is not available for the treatment of Acute Myocardial Infarction patients in the early hours after the onset of the symptoms. The aim of this study was to evaluate the safety and effectiveness of the tenecteplase drug vs alteplase  in the treatment of STEMI patients. We searched the PubMed, cochrane library, Web Of Science for safety and clinical effectiveness. we hand searched US, european, and iranian cardiovascular journals. Randomized clinical trials that included comparison TNKase with alteplase drugs alone OR with other drugs in STEMI patients in English, Persian and Korean languages were selected in this study. Two review authors  independently assessed RCTs studies eligibility and quality. Finally, the data were analysis with Review Manager v 5.3. there was no statistically significant difference between tenecteplase and alteplase in risk of 30 day mortality(RR=1.01;95% CI:0.89-1.13, p=0.82).the risk of Reinfarction, cardiogenic shock ,ICH, stroke and minor bleeding were similar in AMI patients treated With both drugs. tenecteplase was associated with a statistically significant reduction total bleeding and major bleeding , Respectively (p=0.0003)and(p=0.0003). tenecteplase in comparison with alteplase is recommended due to the easier use and better safety in reducing the risk of bleeding.