Risk of intracerebral haemorrhage with alteplase after acute ischaemic stroke: a secondary analysis of an individual patient data meta-analysis

Publication date: Available online 8 June 2016 Source:The Lancet Neurology Author(s): William N Whiteley, Jonathan Emberson, Kennedy R Lees, Lisa Blackwell, Gregory Albers, Erich Bluhmki, Thomas Brott, Geoff Cohen, Stephen Davis, Geoffrey Donnan, James Grotta, George Howard, Markku Kaste, Masatoshi Koga, Rüdiger von Kummer, Maarten G Lansberg, Richard I Lindley, Patrick Lyden, Jean Marc Olivot, Mark Parsons, Danilo Toni, Kazunori Toyoda, Nils Wahlgren, Joanna Wardlaw, Gregory J del Zoppo, Peter Sandercock, Werner Hacke, Colin Baigent Background Randomised trials have shown that alteplase improves the odds of a good outcome when delivered within 4·5 h of acute ischaemic stroke. However, alteplase also increases the risk of intracerebral haemorrhage; we aimed to determine the proportional and absolute effects of alteplase on the risks of intracerebral haemorrhage, mortality, and functional impairment in different types of patients. Methods We used individual patient data from the Stroke Thrombolysis Trialists' (STT) meta-analysis of randomised trials of alteplase versus placebo (or untreated control) in patients with acute ischaemic stroke. We prespecified assessment of three classifications of intracerebral haemorrhage: type 2 parenchymal haemorrhage within 7 days; Safe Implementation of Thrombolysis in Stroke Monitoring Study's (SITS-MOST) haemorrhage within 24–36 h (type 2 parenchymal haemorrhage with a deteri...
Source: The Lancet Neurology - Category: Neurology Source Type: research