Stroke trials: what have we learned?
We reviewed the recent, major, therapeutic trials of intravenous thrombolytic therapy and ancrod for ischemic stroke. Randomized, controlled studies of acute ischemic stroke treatment were reviewed. Several post-FDA approval intravenous tPA studies were reviewed to understand the experience of this medication in practice. STAT trial was the major study using ancrod. Of multiple intravenous thrombolytic studies, the NINDS study of intravenous tPA was the only study to demonstrate a significantly higher percentage of patients with complete recovery or minimal deficit at three months. Studies in communities utilizing intravenous tPA for stroke illustrate the need for close adherence to the NINDS study protocol or else the risk of tPA use may exceed the benefits.
Madhavan
Ramesh
R
Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA.
Jacobs
Bradley S
BS
Levine
Steven R
SR
D000721:Ancrod / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D018696:Neuroprotective Agents / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D018696:Neuroprotective Agents; D000721:Ancrod; D010959:Tissue Plasminogen Activator