Key result
In acute ischemic stroke patients treated 3 to 5 hours after symptom onset, rtPA therapy showed a trend toward benefit across 4 stroke scales in a prespecified low-risk subgroup (P=0.10).
Why the study?
Does recombinant tissue plasminogen activator (rtPA) improve outcomes in acute ischemic stroke patients at low risk for intracranial hemorrhage when treated beyond 3 hours from symptom onset?
Population
Patients with acute ischemic stroke treated mostly between 3 and 5 hours after symptom onset from the…
Comparison
Recombinant tissue plasminogen activator (rtPA) vs Control group
Design
Cohort
Authors
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Should not change rtPA time-window practice; leaves open possible benefit in low-risk subgroup.
RCT (n=194)
Does recombinant tissue plasminogen activator (rtPA) improve outcomes in acute ischemic stroke patients at low risk for intracranial hemorrhage when treated beyond 3 hours from symptom onset?
Effect estimate: 5% to 12% absolute treatment benefit
p-value: p=0.10
A multivariate clinical index may help identify acute ischemic stroke patients at low risk for intracranial hemorrhage who could benefit from rtPA therapy beyond the standard 3-hour window.
Kent et al. (2003) conducted an RCT in Acute ischemic stroke (n=194). Recombinant tissue plasminogen activator (rtPA) was evaluated on Global test of significance across 4 outcome scales (5% to 12% absolute treatment benefit, p=0.10). In acute ischemic stroke patients treated 3 to 5 hours after symptom onset, rtPA therapy showed a trend toward benefit across 4 stroke scales in a prespecified low-risk subgroup (P=0.10).
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