title: Implementation and outcome of thrombolysis with alteplase 3 to 4.5 h after acute stroke in Chinese patients.
abstract: OBJECTIVE
  The European Cooperative Acute Stroke Study (ECASS) III showed that intravenous recombinant tissue plasminogen activator (rtPA) administered in the 3 to 4.5 h after symptom onset significantly improved clinical outcomes in patients with acute ischemic stroke (AIS). But little is known regarding the safety and efficacy of intravenous rtPA treatment within this extended time window in Chinese patients with AIS.
  
  
  RESULTS
  Data were collected from the Thrombolysis Implementation and Monitor of acute ischemic Stroke in China (TIMS-China). A total of 574 patients who underwent rtPA therapy within 4.5 h after symptom onset were included in this study: 409 in the 0- to 3-h group and 165 in the 3- to 4.5-h group. There were no significant differences in SICH rate (2.4% vs. 1.5%, P = 0.70) at 24 to 36 h, mortalities (7.5% vs. 7.3%, P = 0.84), independence rate (68.9% vs. 63.9%, P = 0.19), and excellent recovery rate (60.9% vs. 52.4%, P = 0.11) between the two time window groups. These results were comparable with previous Western studies.
  
  
  CONCLUSIONS
  This study suggests that intravenous rtPA treatment at 3 to 4.5 h of symptom onset remains safe and effective in Chinese patients with AIS.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China.
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Liao
authors.forename: Chun-Xue
authors.initials: CX
authors.lastname: Wang
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Chun-Juan
authors.initials: CJ
authors.lastname: Wang
authors.forename: Xing-Quan
authors.initials: XQ
authors.lastname: Zhao
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Zhang
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Liu
authors.forename: Yue-Song
authors.initials: YS
authors.lastname: Pan
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator