SGEM Xtra: No Retreat, No Surrender – Thrombolysis for Acute Ischemic Stroke

Trials extracted from the podcast by Dr. Ken Milne

• 1995NINDSAnticoagulation & AntithromboticsIn 624 patients with acute ischemic stroke, intravenous t-PA within three hours of onset improved disability at three months compared with placebo.
• 2012IST-3Anticoagulation & AntithromboticsIn 3035 patients with acute ischaemic stroke within 6 h, intravenous alteplase did not increase survival free of dependency at 6 months versus open control.
• 2014Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic strokeAnticoagulation & AntithromboticsIn6756 patients with acute ischaemic stroke,intravenous alteplaseincreaseddisability-free survival at 3-6 monthscompared withplacebo or open control.
• 2013GWTG-StrokeAnticoagulation & AntithromboticsIn 58,353 patients with acute ischaemic stroke, intravenous alteplase given 15 minutes earlier was associated with lower in-hospital mortality than later treatment.