ABSTRACT
BACKGROUND: Tenecteplase is used as an alternative to alteplase and is considered noninferior for thrombolysis in acute ischemic stroke. OBJECTIVES: To compare the effectiveness and adverse effects of tenecteplase and alteplase in the real-world management of acute ischemic stroke. MATERIALS AND METHODS: In this retrospective observational study, we collected data from acute ischemic stroke patients admitted in six hospitals in West Bengal, India, and were thrombolysed with tenecteplase or alteplase between July 2021 and June 2022. Demographic data, baseline parameters, hospital course, and 3-month follow-up data were collected. The percentage of patients achieving a score of 0-2 in the modified Ranking scale at 3 months, rate of symptomatic intracranial hemorrhage, and all-cause mortality within 3 months were the main parameters of comparison between the two thrombolytic agents. RESULTS: A total of 162 patients were initially included in this study. Eight patients were excluded due to unavailability of follow-up data. Among the remaining patients, 71 patients received tenecteplase and 83 patients received alteplase. There was no statistically significant difference between tenecteplase and alteplase with respect to the percentage of patients achieving functional independence (modified Rankin scale score 0-2) at 3 months (53.5% vs. 60.2%, P = 0.706), rate of symptomatic intracranial hemorrhage (5.6% vs. 10.8%, P = 0.246), and all-cause mortality at 3 months (11.3% vs. 15.7%, P = 0.628). CONCLUSION: The effectiveness of tenecteplase is comparable to alteplase in the real-world management of acute ischemic stroke. Symptomatic intracranial hemorrhage and all-cause mortality rates are also similar in real-world practice.
ABSTRACT
A new ternary compound Cu3ZnSb was synthesized by high temperature solid state synthesis and characterized by single crystal X-ray diffraction and energy dispersive X-ray analysis. The ternary Cu3ZnSb crystallizes in the tetragonal crystal system with the space group P4/ nmm (129), and its unit cell contains 10 atoms which are distributed over 4 independent crystallographic positions. The structure is built up with [Cu3Sb] slabs that correspond to the unit cells of Cu2Sb and planar 44 nets of Zn atoms. The planar nets of Zn atoms are interspersed between two adjacent [Cu3Sb] slabs. The structure can be viewed as alternating units of Cu2Sb and CsCl type ß'-brass (CuZn) structures in the [001]. An unusual atomic ordering of two neighboring transition metals Cu and Zn is observed and is confirmed by first principle calculations. The atomic ordering of Cu and Zn is retained from binary ß'-brass structure (CuZn) to ternary Cu3ZnSb. Total energy calculations confirmed the experimental model of Cu/Zn ordering to be the most stable in the structure of Cu3ZnSb. The calculated density of states (DOS) and crystal orbital Hamiltonian population (COHP) explain the stability and bonding characteristics in the structure of Cu3ZnSb. The implication of the persistent Cu/Zn ordering in ternary phases for materials design is emphasized.
