Thrombolysis in Stroke Despite Contraindications or Warnings?
Why the study?
Does intravenous alteplase improve 90-day modified Rankin Scale scores in acute ischemic stroke patients with contraindications or warnings compared to no treatment?
Population
9,613 ischemic stroke patients registered in a trials archive, including subgroups with contraindications or…
Comparison
Intravenous thrombolysis with alteplase vs No thrombolysis treatment
Design
Cohort
Follow-up
90 days
Authors
Discussion
Loading...
Member takes
Implication
May support alteplase in select contraindicated subgroups; leaves open need for randomized confirmation.
Structured PICO
Does intravenous alteplase improve 90-day modified Rankin Scale scores in acute ischemic stroke patients with contraindications or warnings compared to no treatment?
P
Population
9,613 ischemic stroke patients registered in a trials archive, including subgroups with contraindications or warnings (e.g., age >80, prior stroke and diabetes, prior antiplatelet use, oral anticoagulation with INR ≤1.7, baseline glucose >180, NIHSS >22).
I
Intervention
Intravenous thrombolysis with alteplase
C
Comparator
No thrombolysis treatment
O
Outcome
90-day modified Rankin Scale across the whole distribution of scoreshard clinical
Intravenous alteplase is associated with improved 90-day outcomes in acute ischemic stroke patients even in the presence of traditional contraindications or warnings.
Limitations
- Retrospective analysis
Cite This Study
Frank et al. (2013) studied this question.