Article Text

PDF
Randomised controlled trial
Odds of favourable 3-month outcome following ischaemic stroke are greatest when treatment with intravenous alteplase is initiated up to 90 min following event, with no benefit seen if alteplase is given after 270 min
  1. Richard I Lindley
  1. Discipline of Medicine, Sydney Medical School - Westmead, The University of Sydney, New South Wales, Australia
  1. Correspondence to Richard I Lindley
    Westmead Hospital (C24), The University of Sydney, NSW 2006, Australia; richard.lindley{at}sydney.edu.au

Statistics from Altmetric.com

Commentary on:

Context

Thrombolysis for acute ischaemic stroke is an effective treatment that has been extremely difficult to implement. Of the many barriers to implementation (eg, delayed admission to hospital and poor acute stroke infrastructure), the very short treatment window has been the most challenging. Alteplase has generally only been approved for treatment up to 3 h from stroke onset. This study specifically addresses the effectiveness of alteplase by treatment delay.

Methods

This updated individual patient meta-analysis incorporates new data from two further completed randomised controlled trials, ECASS III (821 patients) and EPITHET (100 patients), with all included trials having a time window of less than 6 h. The population consisted of patients in seven completed trials over the past two decades. They excluded patients who were treated after 6 h, therefore the analysis is not ‘intention to treat’. The included trials were double blind but because of the difficulty of masking the biological effects of alteplase, …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.