{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:13:40Z","timestamp":1790010820712,"version":"4.0.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Intracranial haemorrhage (ICH) is a significant complication of fibrinolytic therapy for ST-elevation myocardial infarction (STEMI). The risk factors for ICH following tenecteplase (TNK) administration were evaluated, and a clinical risk prediction tool was developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A pooled individual patient data analysis from STEMI patients who received weight-adjusted TNK with a consistent blood pressure exclusion criterion of &amp;gt;180\/110\u2005mmHg in six randomized controlled trials (ASSENT-2, ASSENT-3, ASSENT-3 PLUS, ASSENT-4 PCI, STREAM, STREAM-2) was undertaken. Logistic regression was used to model risk factors, and a nomogram was developed for individual risk prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 15 954 patients, 169 developed ICH. Above a systolic blood pressure (SBP) threshold of 110\u2005mmHg, each 1\u2005mmHg increase conferred a 2% relative increase in ICH risk [adjusted odds ratio (aOR) 1.02, 95% confidence interval (CI) 1.01\u20131.03; P &amp;lt; .0001]; risk accelerated sharply beyond 160\u2005mmHg. With increasing dose, the likelihood of ICH increased with age, rising from 1% per year (30\u2005mg TNK) to nearly 7% per year with 50\u2005mg. The multivariable model incorporating age, sex, SBP, body weight, and TNK dose with the age\u2013dose interaction demonstrated good discrimination (C index 0.718; 95% CI 0.68\u20130.76). Female sex conferred a 49% increased ICH risk (aOR 1.49, 95% CI 1.06\u20132.11; P = .023), and each 5\u2005kg decrease in body weight was associated with 16% increased odds of ICH (aOR 1.16, 95% CI 1.03\u20131.30; P = .014).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dose reduction of TNK in older patients and SBP optimization before fibrinolytic administration represent modifiable strategies to potentially reduce ICH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehag754","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:24:29Z","timestamp":1788521069000},"source":"Crossref","is-referenced-by-count":0,"title":["Intracranial haemorrhage following tenecteplase fibrinolysis for acute myocardial infarction"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0460-3445","authenticated-orcid":false,"given":"Paul W","family":"Armstrong","sequence":"first","affiliation":[{"name":"Canadian VIGOUR Centre, University of Alberta , 4-120 Katz Group Centre for Pharmacy and Health Research, Edmonton, Alberta , T6G 2E1","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0594-6490","authenticated-orcid":false,"given":"Thierry","family":"Danays","sequence":"additional","affiliation":[{"name":"TDC , Aix-en-Provence ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1082-5981","authenticated-orcid":false,"given":"Cynthia M","family":"Westerhout","sequence":"additional","affiliation":[{"name":"Canadian VIGOUR Centre, University of Alberta , 4-120 Katz Group Centre for Pharmacy and Health Research, Edmonton, Alberta , T6G 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