| Abstract | BACKGROUND: The administration of tissue plasminogen activator (t-PA) has been proven effective for ischemic stroke within 3 h after onset. A pooled-analysis of six trials showed that intravenous t-PA still improves outcome when given between 3 to 4.5 h after stroke onset. On the basis of this pooled analysis, t-PA was also routinely offered to our patients between 3-4.5 h. We report the safety and clinical features of this group together with the features of the group given t-PA within 3 h. METHODS: Prospectively patient characteristics, stroke severity, stroke subtype, incidence of symptomatic intracerebral hemorrhage (SICH), in-hospital mortality, and 3-months modified Rankin Scale scores (mRS) were registered. Data was analyzed separately for patients treated within 3 h (early group) and those treated between 3-4.5 h (late group). RESULTS: Among 176 patients who underwent intravenous thrombolysis, 101 were treated in the early group and 75 in the late group. Six (5.9%; 95% CI 2.8%-12.3%) patients in the early group and 4 (5.3%; 95% CI 2.2%-12.9%) in the late group developed SICH (p=1.0). In the early group 13 (12.9%; 95% CI 7.7%-20.8%) patients died within 7 days after admission, compared to 5 (6.7%; 95% CI 3.0%-14.7%) in the late group (p=0.179). In the early group 44 (43.6%; 95% CI 43.3%-53.3%) were independent (mRS< or =2) at three months, compared to 36 (48.0%; 95% CI 37.0%-59.1%) in the late group (p=0.559). CONCLUSION: Our data show no trend of decreased safety of thrombolysis beyond 3 h. Due to a small sample size a harmful effect cannot be excluded but seems unlikely. |
| Authors | M Uyttenboogaart, P C A J Vroomen, R E Stewart, J De Keyser, G J Luijckx
(Affiliation: Department of Neurology, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. m.uyttenboogaart at neuro.umcg.nl)
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| Journal | Journal of the neurological sciences
(J Neurol Sci)
Vol. 254
Issue 1-2
Pg. 28-32
(Mar 15 2007)
ISSN: 0022-510X Netherlands |
| PMID | 17257623
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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| Chemical References |
- Fibrinolytic Agents
- Tissue Plasminogen Activator
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| Topics |
- Adult
- Aged
- Aged, 80 and over
- Brain Ischemia
(drug therapy, mortality, physiopathology)
- Cerebral Hemorrhage
(chemically induced, prevention & control, radiography)
- Drug Administration Schedule
- Female
- Fibrinolytic Agents
(administration & dosage, adverse effects)
- Humans
- Injections, Intravenous
(adverse effects)
- Male
- Predictive Value of Tests
- Prospective Studies
- Risk Assessment
- Risk Factors
- Stroke
(drug therapy, mortality, physiopathology)
- Thrombolytic Therapy
(adverse effects, mortality, standards)
- Time Factors
- Tissue Plasminogen Activator
(administration & dosage, adverse effects)
- Tomography, X-Ray Computed
(standards)
- Treatment Outcome
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