What question did this study set out to answer?

To evaluate whether shorter onset-to-treatment time with recombinant tissue-type plasminogen activator improves neurological outcomes and impacts intracranial hemorrhage risk in acute stroke.

December 12, 2000Neurology

Early stroke treatment associated with better outcome

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Authors

JMJohn R. MarlerUniversity of Iowa BTBarbara C. TilleyThe University of Texas Health Science Center at Houston MLMei LüHarvard University

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Implication

Randomized trial analysis demonstrates superior functional recovery with earlier thrombolysis in acute stroke, highlighting the clinical benefit of reducing onset-to-treatment time.

Key Points

To evaluate whether shorter onset-to-treatment time with recombinant tissue-type plasminogen activator improves neurological outcomes and impacts intracranial hemorrhage risk in acute stroke.
Conducted secondary analyses of NINDS rt-PA Stroke Study data stratified by onset-to-treatment time (0 to 90 minutes vs. 91 to 180 minutes).
Identified potential masking confounders via univariate analyses and modeled onset-to-treatment interactions adjusting for baseline NIH Stroke Scale score (significance threshold p ≤ 0.10).
A significant onset-to-treatment time interaction was identified for 24-hour neurological improvement without confounding (p = 0.08).
After adjusting for baseline NIHSS, rt-PA treatment produced higher odds of a favorable 3-month outcome at 0 to 90 minutes (adjusted OR 2.11, 95% CI 1.33–3.35) compared to 91 to 180 minutes (adjusted OR 1.69, 95% CI 1.09–2.62; interaction p = 0.09).
No significant effect of onset-to-treatment time on the risk of intracranial hemorrhage within 36 hours was detected among rt-PA-treated participants after baseline NIHSS adjustment.

Cite This Study

Marler et al. (2000) studied this question.

synapsesocial.com/papers/6a7cb2d91b0fae09726ee908 https://doi.org/10.1212/wnl.55.11.1649

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Implication

Randomized trial analysis demonstrates superior functional recovery with earlier thrombolysis in acute stroke, highlighting the clinical benefit of reducing onset-to-treatment time.

Early stroke treatment associated with better outcome

Discussion

Member takes

Implication

Key Points

Cite This Study

Early stroke treatment associated with better outcome

Discussion

Member takes

Implication

Key Points

Cite This Study

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