SGEM Xtra: The NNT is Mellow Yellow for tPA in Acute Ischemic Stroke

Ensaios extraídos do podcast de Dr. Ken Milne

• 2016Why is there still a debate regarding the safety and efficacy of intravenous thrombolysisAnticoagulation & AntithromboticsIn 10,431 patients with acute ischaemic stroke, IV thrombolysis improved good functional outcome but increased haemorrhage and early death compared with control.
• 2014Effect of treatment delay, age, and stroke severity on alteplase for acute ischaemic strokeAnticoagulation & AntithromboticsIn6756 patients with acute ischaemic stroke,intravenous alteplaseincreaseddisability-free survival at 3–6 monthscompared withplacebo or open control.
• 2014Thrombolysis for acute ischaemic stroke (Cochrane systematic review)Anticoagulation & AntithromboticsIn 10,187 patients with acute ischaemic stroke, thrombolysis lowered death or dependency at three to six months compared with control.
• 1995NINDS Part IIAnticoagulation & AntithromboticsIn333 patients with acute ischaemic stroke treated within 3 hours of onset,intravenous t-PAincreasedfavourable outcome at 3 monthscompared withplacebo.
• 2008ECASS IIIAnticoagulation & AntithromboticsIn 821 patients with acute ischaemic stroke treated 3 to 4.5 hours after onset, intravenous alteplase improved 90-day disability-free outcome compared with placebo.
• 2012IST-3Anticoagulation & AntithromboticsIn 3035 patients with acute ischaemic stroke within 6 h, intravenous rt-PA did not significantly improve independent survival at 6 months versus control care.