RecentRCT

TENET

Tenecteplase vs Alteplase in Mechanical Prosthetic Heart Valve Thrombosis: The TENET Randomized Clinical Trial.

JAMA cardiology, 2025 · Single-center open-label noninferiority randomized trial

Population: 83 obstructive mechanical PVT patients at one Indian center
Intervention: Weight-based bolus tenecteplase
Comparator: Low-dose slow alteplase
Primary outcome: Complete thrombolytic success/noninferiority and major complications
Result: 97.5% versus 81.5% success; met noninferiority criterion; small safety sample.

What the trial found

97.5% versus 81.5% success; met noninferiority criterion; small safety sample.

Clinical interpretation

Published online December 2025, print 2026. Not proof of equivalent bleeding or universal tenecteplase superiority; specialist protocol required.

Low certainty

Clinical Context & Relevant Topics (1)

Disease Reference

Critical AS, acute AR/MR mechanics, prosthetic valve emergencies, and infective endocarditis with multidisciplinary surgical triggers.