Feasibility and outcomes of intravenous thrombolysis 3-4.5 hours after stroke in Chinese patients.
The time window for intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment in acute ischemic stroke (AIS) patients has been extended to 4.5 hours. But little is known about the safety and efficacy of IV rt-PA treatment in the 3-4.5 hour time window in Chinese patients with AIS. A total of 119 patients who were treated with standard IV rt-PA therapy within 4.5 hours after symptom onset were included in this study: 85 were treated within 0-3 hours and 34 were treated within 3-4.5 hours. Favorable outcome was defined as a modified Rankin scale (mRS) score of 0-1 at 6 months. The safety of IV rt-PA treatment was assessed by the rate of mortality, symptomatic intracerebral hemorrhage (SICH) and other common complications. There were no significant differences in SICH rates (2.94% versus 2.35%; p=0.85) at 24-36 hours, mortality (5.88% versus 3.53%; p=0.56), other complications (14.71% versus 11.76%; p=0.66), National Institutes of Health Stroke Scale (NIHSS) score improvement at 24 hours (41.18% versus 45.88%; p=0.64) and favorable mRS at 6 months (52.94% versus 54.12%; p=0.91) between the two time window groups. Multivariate analysis showed that advanced age, lower admission NIHSS score and shorter time from symptom onset to treatment were associated with a favorable clinical outcome. This finding showed an additional 29% of patients received IV rt-PA because of the treatment window expansion to 4.5 hours. IV rt-PA was feasible and safe for treating AIS patients in the 3-4.5 hour time window in our Chinese population.
Department of Neurology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Hongshan District, Wuhan 430070, People's Republic of China.
Zhi-Peng
ZP
Xu
Department of Neurology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Hongshan District, Wuhan 430070, People's Republic of China. Electronic address: xzhp14@sina.com.
Hong-Hua
HH
Li
Department of Psychology, South-Central University for Nationalities, WuHan, People's Republic of China.
Ya-Hong
YH
Li
Department of Neurology, 187 Hospital of the People's Liberation Army, Haikou, People's Republic of China.
Yong
Y
Zhang
Department of Neurology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Hongshan District, Wuhan 430070, People's Republic of China.
Qiang
Q
Wu
Department of Neurology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Hongshan District, Wuhan 430070, People's Republic of China.
Lang
L
Lin
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology*; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
D010959:Tissue Plasminogen Activator
Acute stroke; China; Thrombolysis