Exploring the Latest Advances in Tenecteplase in the Treatment of Acute ST-Segment Elevation Myocardial Infarction

Acute ST-segment elevation myocardial infarction (STEMI) is a life-threatening condition where rapid reperfusion therapy is critical for improving patient outcomes. As a next-generation targeted thrombolytic agent, tenecteplase optimizes the structure of tissue-type plasminogen activator (t-PA), significantly extending its half-life, enhancing specificity, and improving resistance to PAI-1. These modifications result in superior thrombolytic speed, safety, and efficacy. Clinical studies demonstrate that intravenous tenecteplase effectively improves cardiac function, increases vascular recanalization rates, and reduces myocardial damage and bleeding risks in STEMI patients, outperforming urokinase and streptokinase. Additionally, intracoronary tenecteplase combined with emergency PCI shows promising potential in patients with high thrombus burden, effectively reducing thrombotic load, optimizing microcirculatory perfusion, and maintaining a favorable safety profile. However, current research is predominantly limited to small-scale or single-center trials, highlighting the need for larger, multicenter studies to further validate its therapeutic benefits. While intracoronary tenecteplase has not been widely adopted internationally, China’s domestically developed tenecteplase (Mingfule) has achieved positive clinical results. Future research should explore the broader potential of tenecteplase in STEMI treatment, particularly in combination therapies and personalized treatment strategies.