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Comparative Study
. 2024 Aug 23;24(1):441.
doi: 10.1186/s12872-024-04121-5.

Adverse events of tissue plasminogen activators in acute myocardial infarction patients: a real-world and pharmacovigilance database analysis

Fangying Liu  1   2 , Guo Yang  1 , Jia Xie  1   2 , Puguang Xie  1 , Fating Zhou  2 , Fan Yang  1 , Yu Ma #  3   4 , Fan Xu #  5
Affiliations
Comparative Study

Adverse events of tissue plasminogen activators in acute myocardial infarction patients: a real-world and pharmacovigilance database analysis

Fangying Liu et al. BMC Cardiovasc Disord. .

Abstract

Background: Tissue plasminogen activator (tPA) is recommended as the preferred thrombolytic therapy for acute myocardial infarction (AMI). This study aimed to explore tPA-related adverse events (AEs) reported in the United States Food and Drug Administration Adverse Event Reporting System (FAERS), assess the potential safety of three preferred tPA therapies for treating AMI, and provide guidance for selecting tPA for prehospital thrombolysis.

Method: Four algorithms, including ROR, PRR, BCPNN, and MGPS, were used to quantify the signals of Tenecteplase, Reteplase, and Alteplase related AEs and compare the differential degrees of the three tPA-associated AEs in the actual data.

Result: We detected 18 signals of Tenecteplase-induced AE, 29 signals of Reteplase-induced AE, and 22 signals of Alteplase-induced AE. Among the three drugs, Tenecteplase had the highest signal intensity for intracranial hemorrhage-related AE, followed by Alteplase. Besides, Reteplase had the highest signal intensity for procedure-related AE and Alteplase had the highest signal intensity for arrhythmia-related AE. The time-onset analysis indicates that we should be vigilant for AEs, especially within the first week and the first 1-2 days after medication.

Conclusion: This study identified and compared the signals of AE related to Tenecteplase, Reteplase, and Alteplase in AMI patients.

Keywords: AMI; Alteplase; FAERS; Pharmacovigilance; Reteplase; Tenecteplase.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The process of selecting three tissue-type plasminogen activators associated AEs in AMI patients from FAERS database
Fig. 2
Fig. 2
Venn diagrams of potential AEs detected from FAERS at the preferred term (PT) level for (A) Tenecteplase, (B) Reteplase, and (C) Alteplase in AMI patients
Fig. 3
Fig. 3
Forest diagrams of signal strength of reports of tPAs at the preferred term (PT) level in the FAERS database. The number of reporting in PT levels > 10 were showed
Fig. 4
Fig. 4
The onset time of AEs related to (A) Tenecteplase, (B) Reteplase, and (C) Alteplase in AMI patients
See this image and copyright information in PMC

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