Comparison of 2 and 3 generations of thrombolytic drugs in patients with acute coronary syndrome with ST segment elevation and ticagrelor administration no later than 3 hours after the end of fibrinolysis by frequency and severity of bleeding

Objective: compare the frequency and severity of bleeding thrombolytic drugs 2 (alteplase) and 3 generations (recombinant prourokinase) in patients with acute coronary syndrome with St segment elevation and the appointment of ticagrelor no later than 3 hours after the end of fibrinolysis. Material and methods: The study included 101 patients: the alteplase group (n = 71) - actilize was used as a thrombolytic drug, and the prourokinase group (n = 30) - purolase was used.a comparison of the groups of alteplase (n = 71) and recombinant prourokinase (n = 30) in patients with acute coronary syndrome with St segment elevation and ticagrelor administration no later than 3 hours after the end of fibrigolysis was performed. The follow-up period for patients was 30 days after thrombolysis. The primary endpoint was bleeding of any localization and severity. The severity of hemorrhagic complications was assessed using TIMI and BARC scales. Results: in the compared groups, there were no cases of fatal and intracranial bleeding; in the alteplase and purolase groups, minor bleeding was recorded 5 (7%) and 2 (6.7%), respectively, moderate bleeding - 2 (2.8%) and 0, respectively, and large bleeding - 1 (1.4%) and 0, respectively. There were no significant differences in the frequency and severity of bleeding between the groups of alteplase and prourokinase, namely: the frequency of bleeding (OR = 1.78; 95% CI = 0.35÷8.91; p = 0.73), the frequency of “heavy” bleeding (p = 0.66) and the frequency of “light” bleeding (OR = 1.53; 95% CI = 0.3÷7.84; p = 0.9). Conclusion: there are no significant differences in the criteria for hemorrhagic safety between groups of patients with acute St-segment elevation coronary syndrome and early administration of ticagrelor after thrombolytic therapy with alteplase or recombinant prourokinase.