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Specialty: Internal Medicine
Drug: Activase

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Total 51 results found since Jan 2013.

Timing of thrombolysis for acute ischaemic stroke: the earlier the treatment the better the outcome, irrespective of age or stroke severity
This study looked at how treatment delay, patient age and stroke severity influence the effect of t-PA in AIS in terms of functional outcome, mortality and intracranial haemorrhage (ICH). Methods This was a preplanned meta-analysis of individual patient data from nine randomised clinical trials of intravenous alteplase for AIS. The primary efficacy measure was the proportion of patients who achieved a 3–6 month...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Lorenzano, S. Tags: Epidemiologic studies, Stroke, Radiology, Clinical diagnostic tests Therapeutics/Prevention Source Type: research

Stroke in the acute setting
Acute stroke and transient ischaemic attack (TIA) are focal neurological syndromes of vascular origin and should be treated as medical emergencies. Brain imaging with computed tomography or magnetic resonance imaging is required to distinguish ischaemic stroke from intracerebral haemorrhage, recognize non-stroke pathologies that mimic stroke and guide investigation into the underlying mechanism. Acute interventions of benefit in ischaemic stroke include intravenous thrombolysis with alteplase given within 4.5 hours of onset, endovascular thrombectomy within 6 hours of onset in selected patients, stroke unit care and aspirin.
Source: Medicine - January 22, 2017 Category: Internal Medicine Authors: Keith W. Muir Tags: Acute medicine II 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

Thrombolysis with alteplase 3-4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances
We congratulate Alper et al for their reanalysis of the Third European Cooperative Acute Stroke Study.1 They found that after adjusting for baseline imbalances in history of prior stroke and stroke severity, there was no statistical benefit with alteplase, but the harms were reconfirmed. So, the difference in outcome could be fully explained by the baseline imbalance. It is worth remembering that a clinical trial has internal validity if and only if the imbalance between groups, bias in the assessment of outcome, and chance have been excluded as possible explanations for the difference in outcomes. It also reaffirms the fr...
Source: Evidence-Based Medicine - November 25, 2021 Category: Internal Medicine Authors: Fatovich, D. M., Milne, W. K. Tags: Letters Source Type: research

An assessment of point‐of‐care measurement of INR using the Coaguchek®XS Plus system in the setting of acute ischaemic stroke
ConclusionPoint of care INR testing correlates well with laboratory values. The results in this study mostly relate to levels in the normal range. We suggest that it can be appropriately used to shorten door‐to‐needle time.
Source: Internal Medicine Journal - July 30, 2013 Category: Internal Medicine Authors: Dawn Nusa, Isabel Harvey, Abdulrahman Y Almansouri, Simogne Wright, Terry Neeman, Omar Ahmad, Andrew R. Hughes, Christian J. Lueck Tags: Original Article Source Type: research

Assessment of point‐of‐care measurement of international normalised ratio using the CoaguChek XS Plus system in the setting of acute ischaemic stroke
ConclusionPoint‐of‐care INR testing correlates well with laboratory values. The results in this study mostly relate to values in the normal range. We suggest that it can be used to try to shorten door‐to‐needle time.
Source: Internal Medicine Journal - November 15, 2013 Category: Internal Medicine Authors: D. Nusa, I. Harvey, A. Y. Almansouri, S. Wright, T. Neeman, O Ahmad, A. R. Hughes, C. J. Lueck Tags: Original Article Source Type: research

Factors affecting in-hospital delay of intravenous thrombolysis for acute ischemic stroke: A retrospective cohort study
This study was designed to investigate the factors affecting the in-hospital delay of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS). Two hundred and forty-eight consecutive AIS patients treated with intravenous administration of alteplase in Gansu Provincial Hospital from December 2014 to August 2018 were enrolled retrospectively in this study. According to door-to-needle (DTN) time, the patients were divided into either a delay group (DTN time> 60 minutes; n = 184) or a non-delay group (DTN time ≤60 minutes; n = 64). The baseline data, laboratory tests, onset-to-door (OTD) time, door-to-acc...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

In ischemic stroke with viable hypoperfused tissue, alteplase >  4.5 h after last seen well improves function.
In ischemic stroke with viable hypoperfused tissue, alteplase > 4.5 h after last seen well improves function. Ann Intern Med. 2020 May 19;172(10):JC50 Authors: Hill MD Abstract SOURCE CITATION: Tsivgoulis G, Katsanos AH, Malhotra K, et al. Thrombolysis for acute ischemic stroke in the unwitnessed or extended therapeutic time window. Neurology. 2020;94:e1241-8. 31892636. PMID: 32422094 [PubMed - in process]
Source: Annals of Internal Medicine - May 18, 2020 Category: Internal Medicine Authors: Hill MD Tags: Ann Intern Med Source Type: research

In ischemic stroke, thrombectomy alone was noninferior to thrombectomy plus alteplase for functional outcome at 90 days.
Abstract SOURCE CITATION: Yang P, Zhang Y, Zhang L, et al. Endovascular thrombectomy with or without intravenous alteplase in acute stroke. N Engl J Med. 2020;382:1981-93. 32374959. PMID: 32926812 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - September 14, 2020 Category: Internal Medicine Authors: Alberts MJ Tags: Ann Intern Med Source Type: research

Efficacy and safety of intravenous thrombolysis with alteplase for treating acute ischemic stroke at different time windows: A protocol for systematic review and meta-analysis
Conclusions: This study will provide an evidence-based basis for the clinical efficacy of alteplase for treating AIS by thrombolytic therapy at different time windows. Ethics and dissemination: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF Registration number: DOI 10.17605 / OSF.IO / K7PHB
Source: Medicine - December 24, 2020 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Pooled RCTs: Alteplase within 4.5 hours of ischemic stroke improves the likelihood of good outcome.
PMID: 25599363 [PubMed - in process]
Source: Annals of Internal Medicine - January 20, 2015 Category: Internal Medicine Authors: Uchino K Tags: Ann Intern Med Source Type: research

Tenecteplase before thrombectomy for ischemic stroke improved reperfusion compared with alteplase.
PMID: 30128510 [PubMed - in process]
Source: Annals of Internal Medicine - August 21, 2018 Category: Internal Medicine Authors: Mai LM, Oczkowski W Tags: Ann Intern Med Source Type: research

Pooled RCTs: In acute ischemic stroke with salvageable brain tissue, alteplase at 4.5 to 9 hours improved function.
PMID: 31610557 [PubMed - in process]
Source: Annals of Internal Medicine - October 14, 2019 Category: Internal Medicine Authors: Absher JR Tags: Ann Intern Med Source Type: research

In imaging-selected ischemic stroke with unknown onset, alteplase increases favorable outcomes and death at 90 d
Ann Intern Med. 2021 Apr 6. doi: 10.7326/ACPJ202104200-042. Online ahead of print.ABSTRACTThomalla G, Boutitie F, Ma H, et al. Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data. Lancet. 2020;396:1574-84. 33176180.PMID:33819060 | DOI:10.7326/ACPJ202104200-042
Source: Annals of Internal Medicine - April 5, 2021 Category: Internal Medicine Authors: Michael D Hill Source Type: research