Tenecteplase Improves Door‐to‐Needle Time in Real‐World Acute Stroke Treatment

Background We report the interim results of a process improvement initiative at comprehensive stroke center in which all tPA (tissue‐type plasminogen activator)–eligible patients were given tenecteplase for acute ischemic stroke. Methods retrospectively analyzed prospectively maintained single‐center registry consecutive with treated our emergency department or transferred further care. Patients alteplase (tPA) before (October 2019–April 2020) compared those (May 2020–July 2021). The primary efficacy outcome was Target: Stroke Phase II recommendation door‐to‐needle (DTN) time ≤45 minutes. Backward stepwise logistic regression used to estimate an independent effect against DTN Two contemporaneous, negative controls (time first antibiotic who presented infectious symptoms and door‐to‐groin puncture thrombectomy) evaluated confirm unrelated other treatment throughput. Results Of 113 included patients, 53 (47%) received tenecteplase. significantly faster (median, 41 [interquartile range, 34–62] minutes versus 58 45–70] minutes; P <0.01), no significant difference symptomatic intracranial hemorrhage (2% 7%; =0.37). Despite higher proportion being care (with slower time), remained independently predictive (adjusted odds ratio, 3.96; 95% CI, 1.58–9.91). There ( >0.05) door‐to‐puncture when similar periods compared. Conclusions Tenecteplase associated This can likely be attributed ease single bolus administration