{
  "abstract": "Background and aims Tenecteplase (TNK) offers logistical advantages in stroke thrombolytic therapy with its single bolus administration compared with alteplase. We aim to investigate the real-world evidence regarding its safety and effectiveness in China.Methods We conducted a retrospective study on patients receiving alteplase or TNK for acute ischaemic stroke (AIS) within 4.5 hours of onset between 1 March 2019 and 1 October 2023, from 18 stroke centres in China. Using propensity score matching (PSM), TNK-treated patients were matched 1:1 with alteplase-treated patients. The primary outcome was the rate of symptomatic intracranial haemorrhage (sICH) within 72 hours post-thrombolysis. Secondary outcomes comprised the rate of parenchymal haemorrhage type 2, any intracranial haemorrhage, any systematic bleeding and mortality at 90 days, as well as 24-hour National Institutes of Health Stroke Scale (NIHSS), early neurological improvement at 24 hours, modified Rankin Scale (mRS) shift, percentage of mRS 0–1 and mRS 0–2 at 90 days.Results We identified 1113 patients with AIS who received TNK and 2360 patients who received alteplase. Following PSM, 1113 TNK-treated patients with AIS were matched to 1113 patients treated with alteplase. No significant differences were observed in rates of sICH (1.8% vs 1.98%, p=0.864) or other safety outcomes. Moreover, TNK-treated patients demonstrated a lower rate of any intracranial haemorrhage (OR: 0.51, 95% CI: 0.31 to 0.86, p=0.012). A higher proportion of patients achieving early neurological improvement at 24 hours (OR: 1.76, 95% CI: 1.48 to 2.09, p=0.000), better 90-day mRS (OR: 0.67, 95% CI: 0.57 to 0.79, p=0.000) as well as higher percentages of 90-day mRS 0–1 (OR: 1.27, 95% CI: 1.05 to 1.54, p=0.012) and mRS 0–2 (OR: 1.41, 95% CI: 1.14 to 1.75, p=0.001) compared with alteplase.Conclusions Thrombolysis with TNK is not associated with an increased risk of sICH, and may result in better early neurological improvement and 90-day functional outcomes compared with alteplase in patients with AIS.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China",
        "National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China"
      ],
      "name": "Ye Liu"
    },
    {
      "affiliations": [
        "Department of Neurology, Keshiketeng Banner Traditional Chinese Medicine Mongolian Medicine Hospitalorem Ipsum, Keshiketeng, Inner Mongolia, China"
      ],
      "name": "Guozhi Lu"
    },
    {
      "affiliations": [
        "Department of Neurology, Keshiketeng Banner Traditional Chinese Medicine Mongolian Medicine Hospitalorem Ipsum, Keshiketeng, Inner Mongolia, China"
      ],
      "name": "Dan Li"
    },
    {
      "affiliations": [
        "Department of Neurology, Nanshi Hospital Affiliated to Henan University, Nanyang, Henan, China"
      ],
      "name": "Guang Wu"
    },
    {
      "affiliations": [
        "Department of Neurology, Shanghai Tenth People's Hospital, Shanghai, China"
      ],
      "name": "Xiaoyu Zhou"
    },
    {
      "affiliations": [
        "Department of Neurology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China"
      ],
      "name": "Rongbo Qu"
    },
    {
      "affiliations": [
        "Department of Neurology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China"
      ],
      "name": "Yongren Fang"
    },
    {
      "affiliations": [
        "Department of Neurology, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China",
        "National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China"
      ],
      "name": "ZhiJiao He"
    },
    {
      "affiliations": [
        "Department of Neurology, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China",
        "National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China"
      ],
      "name": "Anqi Zhang"
    },
    {
      "affiliations": [
        "Department of Neurology, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China",
        "National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China"
      ],
      "name": "Lan Hong"
    },
    {
      "affiliations": [
        "Department of Neurology, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China",
        "National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China"
      ],
      "name": "Kun Fang"
    },
    {
      "affiliations": [
        "Department of Neurology, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China",
        "National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China"
      ],
      "name": "Xin Cheng"
    },
    {
      "affiliations": [
        "Department of Neurology, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China",
        "National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China"
      ],
      "name": "Qiang Dong"
    },
    {
      "affiliations": [],
      "name": "TTT-AIS CHINA collaborator"
    }
  ],
  "title": "Tenecteplase thrombolytic therapy for acute ischaemic stroke in China: a real-world, multicentre, retrospective, controlled study",
  "uid": "2bbc47f5-6d27-582e-9993-8e348ec8673b"
}