Clot Dissolver Doesn't Boost Survival in Cardiac Arrest Patients
Dec. 18 -- WEDNESDAY, Dec. 17 (HealthDay News) -- German doctors thought that giving the clot-dissolving drug tenecteplase (TKNase) to people with sudden cardiac arrest would improve survival.
Unfortunately, the drug, a form of tissue plasminogen activator (tPA), didn't work as hoped in a trial, but they haven't given up on the idea.
"In specific situations, those patients with pulmonary embolism, use of this thrombolytic agent can stabilize the patient and help the patient survive," said Dr. Bernd W. Böttiger, professor and head of the department of anesthesiology and emergency care medicine at the University of Cologne and lead author of a report in the Dec. 18 issue of the New England Journal of Medicine.
But pulmonary embolism, a blood clot that blocks a heart artery, is the underlying cause of sudden cardiac arrest only 5 percent to 7 percent of the time, Böttiger said. There was a small improvement in survival, though not great enough to be statistically significant, among people with pulmonary embolism in the trial he led, but there was no overall increase in the survival rate.
The trial, done at several European medical centers, was stopped after 443 people were treated for sudden cardiac arrest "because of low survival," the report said. It was started again with a change in the treatment routine but "terminated prematurely for futility after enrolling a total of 1,050 patients."
The 30-day survival rate was actually lower for people given tenecteplase: 14.7 percent versus 17 percent for those getting conventional treatment for cardiac arrest.
Better emergency treatments are desired because, Böttiger said, "in the U.S. and Europe every year, about 400,000 patients are suffering cardiac arrest, and only 5 to 10 percent will survive." The hope was that tenecteplase would dissolve artery-blocking clots that caused the hearts to stop, but it proved to be ineffective in the vast majority of patients -- those whose cardiac arrest was due to blockage of a major heart artery.
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