title: Intravenous Thrombolysis and Risk Factors for Ischemic Stroke.
abstract: Thrombolysis is one of the proven potential treatments for the management of acute ischemic stroke. Intravenous recombinant tissue-plasminogen activator (rt-PA) is the only medically approved biological thrombolysing agent for the treatment of acute ischemic stroke within 4.5h of stroke (2.2% symptomatic intracerebral haemorrhage, 12.7% mortality and 58.0% functional independence), but following the guideline and criteria provided by National Institute of Neurological Disorder and Stroke (NINDS) and SITS (Safe Implementation of Thrombolysis in Stroke) studies. Nepal needs to evidently introduce intravenous rt-PA in its clinical setting for treatment of acute ischemic stroke, which has been approved for more than a decade ago in developed countries. Several modifiable and non-modifiable risk factors can affect the outcomes of the treatment with intravenous rt-PA. Early modification of factors predicting the risk outcomes can be a beneficial tool to justify the thrombolytic treatment. This review aims to discuss the major studies on thrombolysis using rt-PA and main factors that can affect the outcomes of treatment in ischemic stroke.
authors.affiliation: Department of Pharmacy, Shree Medical and Technical College, Chitwan, Nepal.
authors.forename: Shakti
authors.initials: S
authors.lastname: Shrestha
authors.affiliation: Hospital Pharmacy, Chitwan Medical College Teaching Hospital, Chitwan Nepal.
authors.forename: Ramesh Sharma
authors.initials: RS
authors.lastname: Poudel
authors.affiliation: National Institute of Neurological and Allied Sciences, Kathmandu, Nepal.
authors.forename: Lekh Jung
authors.initials: LJ
authors.lastname: Thapa
authors.affiliation: Department of Community Medicine, College of Medical Sciences-Teaching Hospital, Chitwan, Nepal.
authors.forename: Dipendra
authors.initials: D
authors.lastname: Khatiwada
mesh_terms: D061605:Administration, Intravenous; D000367:Age Factors; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D061345:Early Medical Intervention; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: alteplase; ischemic stroke; risk factors; rt-PA; thrombolysis.