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Researchers have hypothesized that up to 70% of out-of-hospital cardiac arrests are caused by thrombotic occlusion of a coronary or pulmonary artery. Promising findings from previous studies of thrombolytics for treatment of patients in cardiac arrest led to this international, manufacturer-sponsored trial. Investigators randomized adults with witnessed out-of-hospital cardiac arrest to receive tenecteplase or placebo during resuscitation. Patients with asystolic, pulseless electrical activity (PEA) or ventricular fibrillation (VF) arrest were included; those with presumed noncardiac causes of arrest or at increased risk for adverse effects of thrombolytic treatment were excluded.
After enrollment of 443 patients, survival of those with asys…