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Condition: Atrial Fibrillation
Drug: Activase

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Total 47 results found since Jan 2013.

Wake-up Stroke and Onset-to-door Duration Delays: Potential Future Indications for Reperfusion Therapy.
Conclusion: The one- third proportion of wake-up stroke in this cohort and low prevalence of relative contraindications suggest this is a promising group for emerging thrombolysis indications. With the majority of patients presenting after 8 hours, widening of the therapeutic window with new potential reperfusion treatments would not appreciably increase treatment utilisation. This study reaffirms the urgent need for public education to improve stroke awareness in Singapore. PMID: 24557460 [PubMed - in process]
Source: Annals of the Academy of Medicine, Singapore - January 1, 2014 Category: Journals (General) Authors: Tan MSh, Ang ES, Ho SS, Ng SC, Talabucon L, Woon FP, De Silva DA Tags: Ann Acad Med Singapore Source Type: research

Advances in stroke medicine.
Authors: Campbell BC Abstract In recent years, reperfusion therapies such as intravenous thrombolysis and endovascular thrombectomy for ischaemic stroke have dramatically reduced disability and revolutionised stroke management. Thrombolysis with alteplase is effective when administered to patients with potentially disabling stroke, who are not at high risk of bleeding, within 4.5 hours of the time the patient was last known to be well. Emerging evidence suggests that other thrombolytics such as tenecteplase may be even more effective. Treatment may be possible beyond 4.5 hours in patients selected using brain imagi...
Source: Medical Journal of Australia - May 6, 2019 Category: General Medicine Tags: Med J Aust Source Type: research

A Diagnostic Approach to Stroke in Young Adults
Opinion statementOptimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the “standard” vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask iswhy did this patient have a stroke? A “heart to head” diagnostic approach is recommended. A thoro...
Source: Current Treatment Options in Cardiovascular Medicine - September 25, 2017 Category: Cardiology Source Type: research

Predictors of functional outcome and hemorrhagic complications in acute ischemic stroke patients treated with intravenous thrombolysis - A retrospective analysis 
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Predictors of functional outcome and hemorrhagic complications in acute ischemic stroke patients treated with intravenous thrombolysis - A retrospective analysis
. Int J Clin Pharmacol Ther. 2017 Oct 26;: Authors: Zhao Q, Shan W, Liu L, Fu X, Liu P, Hu Y Abstract Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) within 4.5 hours is an effective and routine therapy for acute ischemic stroke (AIS). The purpose of the study was to identify predictors of functional outcome at 3 months and hemorrhagic complications after IVT. A total of 123 AIS patients treated with in...
Source: International Journal of Clinical Pharmacology and Therapeutics - November 4, 2017 Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research

Current Smoking Does Not Modify the Treatment Effect of Intravenous Thrombolysis in Acute Ischemic Stroke Patients —A Post-hoc Analysis of the WAKE-UP Trial
Conclusions: In patients with mild to moderate MRI-proven AIS and unknown time of symptom onset with DWI-FLAIR mismatch, current smokers had worse functional outcome as compared to non-smokers. Current smoking did not modify the treatment effect of alteplase.Clinical Trial registration: Main trial (WAKE-UP): ClinicalTrials.gov, NCT01525290; and EudraCT, 2011-005906-32. Registered 02 February 2012.
Source: Frontiers in Neurology - November 21, 2019 Category: Neurology Source Type: research

Sex-related differences among ischaemic stroke patients treated with intravenous thrombolysis in Poland.
CONCLUSIONS: Of the ischaemic stroke patients treated with intravenous thrombolysis, women had worse long-term outcomes than men. This discrepancy may be explained by the older age and higher proportion of cardio-embolic strokes with more severe baseline deficits. However, multiple logistic analysis did not show that sex itself had an impact on the greater mortality in women after a stroke, or on the poorer prognosis. PMID: 32469076 [PubMed - as supplied by publisher]
Source: Neurologia i Neurochirurgia Polska - May 28, 2020 Category: Neurology Authors: Wiszniewska M, Fryze W, Wiśniewska A, Karliński M, Sobolewski P, Krzykowski G, Członkowska A Tags: Neurol Neurochir Pol Source Type: research

Intravenous thrombolysis is more safe and effective for posterior circulation stroke: Data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China)
Abstract: We aimed to compare the safety and efficacy of intravenous thrombolysis (IVT) with alteplase for anterior circulation stroke (ACS) and posterior circulation stroke (PCS). From a large multicenter prospective registry—the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China database—all patients who received IVT within 4.5 hours after stroke onset was reviewed. According to the clinical presentations and imaging findings, the eligible patients were divided into ACS and PCS groups. The safety and efficacy outcome measures included post-IVT symptomatic intracranial hemorrhage (sICH), paren...
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Endovascular thrombectomy in patients with acute ischemic stroke and atrial fibrillation. A MR CLEAN subgroup analysis.
CONCLUSIONS: This study did not show significant difference in the EVT effect between acute stroke patients with and without AF. PMID: 28649948 [PubMed - as supplied by publisher]
Source: EuroIntervention - June 28, 2017 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Disparities between Asian and Non-Asian Thrombolyzed Acute Ischemic Stroke Patients in the Enhanced Control of Hypertension and Thrombolysis Stroke Trial
Conclusions: Within the context of an international clinical trial of thrombolyzed AIS patients, demography, risk factors, management, and odds of early neurological deterioration and ICH, all differ between Asian and non-Asian participants. However, patterns of functional recovery are similar between these major regional groups.Cerebrovasc Dis
Source: Cerebrovascular Diseases - June 21, 2021 Category: Neurology Source Type: research

Effect of Intravenous Thrombolytic Dose of Alteplase on Long-Term Prognosis in Patients with Acute Ischemic Stroke
ConclusionsStandard-dose alteplase treatment reduced the risk of long-term recurrence of AIS after hospital discharge and the alteplase dose was not associated with the long-term risk of death from AIS.
Source: Neurology and Therapy - May 11, 2023 Category: Neurology Source Type: research

Seminar Stroke
In the past decade, the definition of stroke has been revised and major advances have been made for its treatment and prevention. For acute ischaemic stroke, the addition of endovascular thrombectomy of proximal large artery occlusion to intravenous alteplase increases functional independence for a further fifth of patients. The benefits of aspirin in preventing early recurrent ischaemic stroke are greater than previously recognised. Other strategies to prevent recurrent stroke now include direct oral anticoagulants as an alternative to warfarin for atrial fibrillation, and carotid stenting as an alternative to endarterect...
Source: LANCET - September 12, 2016 Category: Journals (General) Authors: Graeme J Hankey Tags: Seminar Source Type: research

Fatal Intraperitoneal Bleeding after Intravenous Administration of Tissue Plasminogen Activator
We report a case of acute ischemic stroke, which developed fatal intraperitoneal bleeding after intravenous administration of alteplase. An 86-year-old woman developed acute infarction of the right middle cerebral artery during admission for chronic heart failure. Two days before the stroke, liver biopsy was performed; the result was benign. Although rivaroxaban was prescribed for atrial fibrillation, the rivaroxaban had been discontinued for liver biopsy until the time when she developed the stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - April 18, 2015 Category: Neurology Authors: Chise Anan, Masahiro Oomura, Tomoaki Saeki, Toshimasa Ikeda, Chikako Sato, Kentaro Yamada Tags: Case Report Source Type: research

Treatment With Intravenous Alteplase for Acute Ischemic Stroke After Reversal of Dabigatran With Idarucizumab: A Case Study
Treatment options for anticoagulated patients presenting with ischemic stroke are limited. Off-label use of idarucizumab to rapidly reverse the anticoagulant effect of dabigatran may ensure eligibility for thrombolytic therapy with alteplase. This case describes a 77-year-old white male who presented to the hospital 89 minutes after sudden onset of right-sided hemiparesis, dysarthria, and facial palsy. Significant history included atrial fibrillation and previous right-sided cortical stroke. Medication reconciliation revealed he was taking dabigatran 150 mg twice a day, with the last dose being 179 minutes before presentat...
Source: Journal of Neuroscience Nursing - January 8, 2019 Category: Neuroscience Tags: Case Study Source Type: research

Use of Oral Anticoagulants and Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke
To the Editor A recent study examined the safety of intravenous alteplase in patients taking NOACs within 7 days of acute ischemic stroke. Although the authors paired GWTG-Stroke registry data with data from the ARAMIS registry, the time of last NOAC dose was known in only 2% of patients in this study. Moreover, patients taking NOACs within 48 hours of intravenous alteplase experienced a higher rate of symptomatic intracranial hemorrhage compared with the overall NOAC population (8% vs 3.7%), suggesting that alteplase should be avoided within 48 hours of NOAC administration until more comprehensive data are available. A re...
Source: JAMA - June 21, 2022 Category: General Medicine Source Type: research

Thrombectomy with or without Bridging Thrombolysis for Anterior System Stroke
Conclusions: In this study, BT seems to yield better clinical and procedural outcomes with lower complication rates than d-MT. These findings may support the additional value of intravenous alteplase in anterior system strokes. Further large-scale, prospective, randomized-controlled studies will clarify the gray lines in this consensus, but this paper is important for reflecting the real-world data in developing countries.
Source: Neurology India - April 29, 2023 Category: Neurology Authors: Leyla Ramazanoglu Mehmet Kocak Isil Kalyoncu Aslan Yilmaz Onal Murat Velioglu Eren Gozke Source Type: research