ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025
Prehospital thrombolysis with tenecteplase in out-of-hospital cardiac arrest: a retrospective cohort study.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- ''Sugar for the Heart'', a bitter pill for tenecteplase: the crystallisation trap of pre-hospital fibrinolysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Response to: comment on: assessing the futility of thrombolysis in out of-hospital cardiac arrest. A retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- "Assessing the futility of thrombolysis in out-of-hospital cardiac arrest": why resuscitation time bias matters?Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
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Authors and funding
5 authors.
Funding
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Abstract
backgroundThe role of thrombolysis in out-of-hospital cardiac arrest (OHCA) remains uncertain, with limited evidence of benefit. This study evaluated whether prehospital administration of Tenecteplase improves outcomes in patients with presumed thromboembolic OHCA.
methodsA retrospective cohort study was conducted using a regional cardiac arrest registry comprising 2,829 adult OHCA cases. Of these, 171 patients received Tenecteplase in the prehospital setting. Logistic regression was used to assess the association between thrombolysis and two outcomes: 30-day survival (primary) and return of spontaneous circulation (ROSC) at hospital arrival (secondary), adjusting for relevant confounders.
resultsThirty-day survival was 4% in the thrombolysis group versus 10% in controls. Adjusted odds of survival were significantly lower with thrombolysis (OR 0.08, 95% CI 0.04-0.19), as were odds of achieving ROSC (OR 0.21, 95% CI 0.14-0.33). Shockable rhythm (OR 15.89) and witnessed arrest (OR 1.99) were strong independent predictors of survival. Model fit was moderate (McFadden's R² = 0.27).
conclusionPrehospital thrombolysis with Tenecteplase was not associated with improved survival or ROSC in OHCA and may be linked to worse outcomes. These findings highlight a lack of sustained benefit associated with empiric thrombolysis based on suspected thromboembolic cause in OHCA, and raise questions about its routine prehospital use without definitive diagnosis.
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