This study aims at evaluating of the effectiveness of in-hospital thrombolysis for ST-segment elevation myocardial infarction in PCI centers under conditions of predicted in-hospital delay (\>60 min after admission in PCI-center) of PCI. Following randomisation a strategy of early tenecteplase and additional antiplatelet and antithrombin therapy followed by catheterisation within 2-24 hours with timely coronary intervention as appropriate (or by rescue coronary intervention if required) in Group A will be compared to primary PCI performed according to local standards in Group B.
Age equal or greater than 18 years
"Symptom onset-randomization" time interval <12 hours
Predicted "diagnosis-pPCI" time interval equal or greater than 120 minutes
Predicted "admission-pPCI" time interval equal or greater than 60 minutes
Medical history, procedures, medication administration or the presence of factors that would in general predispose to bleeding events and/or the inability to evaluate the study primary endpoint
Parallel
Single, weight-adjusted i.v. bolus of tenecteplase
DrugSingle, weight-adjusted i.v. bolus of tenecteplase in case of \>60 min in-hospital delay in PCI center
catheterisation
Procedure/SurgeryStandard primary PCI
The number of observed patients with cardiovascular death, nonfatal stroke, and nonfatal AMI within 12 months for FAS.
Participants achieved a response if they have cardiovascular death or nonfatal stroke, or nonfatal AMI at 12 months.
Number of patients with all-cause mortality
Number of patients with cardiovascular mortality
Number of patients with non-fatal MI
Number of patients with hemorrhagic stroke
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