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OBJECTIVE: The study aimed to evaluate the efficacy and safety of Revelise (alteplase), a Russian medicinal product used as thrombolytic therapy (TLT) to treat ischemic stroke (IS) in real-world practice. MATERIAL AND METHODS: A total of 2202 patients with IS were included in the study. The mean age was 68 years, with 20% of patients aged 80 years or older. Of the patients, 53.6% were men and 46.4% were women; 233 (10.6%) patients with large vessel occlusion underwent staged reperfusion. The most common comorbidities were hypertension (96%), chronic heart failure (57.3%), coronary artery disease (56.9%), and cardiac arrhythmias (33.8%). Nearly one-third (28.9%) of patients received antiplatelet agents before TLT, whereas 4.7% received anticoagulants. The mean NIHSS score for the entire study population was 10, and 11.6% had disabling symptoms with a NIHSS score< 5. Symptomatic hemorrhagic transformation was determined using the ECASS 3 criteria. RESULTS: 0.001). Twenty-four hours after TLT, 42.8% of patients demonstrated a decrease in their NIHSS score by ≥4. The hospital mortality rate was 8.2%. Symptomatic hemorrhagic transformation developed in 2.5% of patients. Favorable outcomes (mRS 0-2) were reported in 49.9% of patients at discharge and 66.4% of patients 90 days after TLT. CONCLUSION: The obtained results confirm the high efficacy and safety of Revelise in patients with IS. The wide practical use in various patient groups is justified by an up-to-date patient selection algorithm. This includes patients aged 80 years and older with minor stroke (NIHSS score< 5) who receive treatment with antiplatelet agents or anticoagulants, as well as staged reperfusion. The obtained results are consistent with those of previously published studies with a similar design.
Shamalov et al. (Sun,) studied this question.