Different doses of recombinant tissue-type plasminogen activator for acute stroke in Chinese patients

A. Ching Chao, Ching Kuan Liu, Chih Hung Chen, Huey-Juan Lin, Chung Hsiang Liu, Jiann Shing Jeng, Chaur Jong Hu, Chih Ping Chung, Hung Yi Hsu, Wen Yung Sheng, Han Hwa Hu

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE - : The relationship between the dose of recombinant tissue-type plasminogen activator (r-tPA) and its safety/efficacy for ischemic stroke has not been well evaluated in the East Asian population. We assessed the safety/efficacy of different doses of r-tPA for acute ischemic stroke in Chinese patients. METHODS - : A total of 1004 eligible patients were classified according to the dose of r-tPA received for managing acute ischemic stroke: 0.9 mg/kg (n=422), 0.8 mg/kg (n=202), 0.7 mg/kg (n=199), and 0.6 mg/kg (n=181). The safety outcome was symptomatic intracerebral hemorrhage and death within 3 months. The efficacy outcome was good functional outcome (modified Rankin Scale ≤1) at 3 months. RESULTS - : There was a significant trend for symptomatic intracerebral hemorrhage with age (P=0.002). With multivariate logistic regression analysis, a dose of 0.9 mg/kg was a predictor of symptomatic intracerebral hemorrhage (P=0.0109), and a dose ≤0.65 mg/kg was a predictor of good functional outcome (P=0.0369). In patients aged 71 to 80 years, there was a significant trend of increasing symptomatic intracerebral hemorrhage (P=0.0130) and less good functional outcome (P=0.0179) with increasing doses of r-tPA. There was also a trend of increasing mortality (P=0.0971) at 3 months in these patients. CONCLUSIONS - : These results did not support the dose of 0.9 mg/kg of r-tPA being optimal for all patients in the East Asian population. In elderly patients (71-80 years), a lower dose of 0.6 mg/kg is associated with a better outcome. Confirmation of the results through randomized trial is required.

Original languageEnglish
Pages (from-to)2359-2365
Number of pages7
JournalStroke
Volume45
Issue number8
DOIs
Publication statusPublished - 2014

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Tissue Plasminogen Activator
Stroke
Cerebral Hemorrhage
Safety
Population
Logistic Models
Regression Analysis
Mortality

Keywords

  • cerebral hemorrhage
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialised Nursing

Cite this

Different doses of recombinant tissue-type plasminogen activator for acute stroke in Chinese patients. / Chao, A. Ching; Liu, Ching Kuan; Chen, Chih Hung; Lin, Huey-Juan; Liu, Chung Hsiang; Jeng, Jiann Shing; Hu, Chaur Jong; Chung, Chih Ping; Hsu, Hung Yi; Sheng, Wen Yung; Hu, Han Hwa.

In: Stroke, Vol. 45, No. 8, 2014, p. 2359-2365.

Research output: Contribution to journalArticle

Chao, AC, Liu, CK, Chen, CH, Lin, H-J, Liu, CH, Jeng, JS, Hu, CJ, Chung, CP, Hsu, HY, Sheng, WY & Hu, HH 2014, 'Different doses of recombinant tissue-type plasminogen activator for acute stroke in Chinese patients', Stroke, vol. 45, no. 8, pp. 2359-2365. https://doi.org/10.1161/STROKEAHA.114.005245
Chao, A. Ching ; Liu, Ching Kuan ; Chen, Chih Hung ; Lin, Huey-Juan ; Liu, Chung Hsiang ; Jeng, Jiann Shing ; Hu, Chaur Jong ; Chung, Chih Ping ; Hsu, Hung Yi ; Sheng, Wen Yung ; Hu, Han Hwa. / Different doses of recombinant tissue-type plasminogen activator for acute stroke in Chinese patients. In: Stroke. 2014 ; Vol. 45, No. 8. pp. 2359-2365.
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abstract = "BACKGROUND AND PURPOSE - : The relationship between the dose of recombinant tissue-type plasminogen activator (r-tPA) and its safety/efficacy for ischemic stroke has not been well evaluated in the East Asian population. We assessed the safety/efficacy of different doses of r-tPA for acute ischemic stroke in Chinese patients. METHODS - : A total of 1004 eligible patients were classified according to the dose of r-tPA received for managing acute ischemic stroke: 0.9 mg/kg (n=422), 0.8 mg/kg (n=202), 0.7 mg/kg (n=199), and 0.6 mg/kg (n=181). The safety outcome was symptomatic intracerebral hemorrhage and death within 3 months. The efficacy outcome was good functional outcome (modified Rankin Scale ≤1) at 3 months. RESULTS - : There was a significant trend for symptomatic intracerebral hemorrhage with age (P=0.002). With multivariate logistic regression analysis, a dose of 0.9 mg/kg was a predictor of symptomatic intracerebral hemorrhage (P=0.0109), and a dose ≤0.65 mg/kg was a predictor of good functional outcome (P=0.0369). In patients aged 71 to 80 years, there was a significant trend of increasing symptomatic intracerebral hemorrhage (P=0.0130) and less good functional outcome (P=0.0179) with increasing doses of r-tPA. There was also a trend of increasing mortality (P=0.0971) at 3 months in these patients. CONCLUSIONS - : These results did not support the dose of 0.9 mg/kg of r-tPA being optimal for all patients in the East Asian population. In elderly patients (71-80 years), a lower dose of 0.6 mg/kg is associated with a better outcome. Confirmation of the results through randomized trial is required.",
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T1 - Different doses of recombinant tissue-type plasminogen activator for acute stroke in Chinese patients

AU - Chao, A. Ching

AU - Liu, Ching Kuan

AU - Chen, Chih Hung

AU - Lin, Huey-Juan

AU - Liu, Chung Hsiang

AU - Jeng, Jiann Shing

AU - Hu, Chaur Jong

AU - Chung, Chih Ping

AU - Hsu, Hung Yi

AU - Sheng, Wen Yung

AU - Hu, Han Hwa

PY - 2014

Y1 - 2014

N2 - BACKGROUND AND PURPOSE - : The relationship between the dose of recombinant tissue-type plasminogen activator (r-tPA) and its safety/efficacy for ischemic stroke has not been well evaluated in the East Asian population. We assessed the safety/efficacy of different doses of r-tPA for acute ischemic stroke in Chinese patients. METHODS - : A total of 1004 eligible patients were classified according to the dose of r-tPA received for managing acute ischemic stroke: 0.9 mg/kg (n=422), 0.8 mg/kg (n=202), 0.7 mg/kg (n=199), and 0.6 mg/kg (n=181). The safety outcome was symptomatic intracerebral hemorrhage and death within 3 months. The efficacy outcome was good functional outcome (modified Rankin Scale ≤1) at 3 months. RESULTS - : There was a significant trend for symptomatic intracerebral hemorrhage with age (P=0.002). With multivariate logistic regression analysis, a dose of 0.9 mg/kg was a predictor of symptomatic intracerebral hemorrhage (P=0.0109), and a dose ≤0.65 mg/kg was a predictor of good functional outcome (P=0.0369). In patients aged 71 to 80 years, there was a significant trend of increasing symptomatic intracerebral hemorrhage (P=0.0130) and less good functional outcome (P=0.0179) with increasing doses of r-tPA. There was also a trend of increasing mortality (P=0.0971) at 3 months in these patients. CONCLUSIONS - : These results did not support the dose of 0.9 mg/kg of r-tPA being optimal for all patients in the East Asian population. In elderly patients (71-80 years), a lower dose of 0.6 mg/kg is associated with a better outcome. Confirmation of the results through randomized trial is required.

AB - BACKGROUND AND PURPOSE - : The relationship between the dose of recombinant tissue-type plasminogen activator (r-tPA) and its safety/efficacy for ischemic stroke has not been well evaluated in the East Asian population. We assessed the safety/efficacy of different doses of r-tPA for acute ischemic stroke in Chinese patients. METHODS - : A total of 1004 eligible patients were classified according to the dose of r-tPA received for managing acute ischemic stroke: 0.9 mg/kg (n=422), 0.8 mg/kg (n=202), 0.7 mg/kg (n=199), and 0.6 mg/kg (n=181). The safety outcome was symptomatic intracerebral hemorrhage and death within 3 months. The efficacy outcome was good functional outcome (modified Rankin Scale ≤1) at 3 months. RESULTS - : There was a significant trend for symptomatic intracerebral hemorrhage with age (P=0.002). With multivariate logistic regression analysis, a dose of 0.9 mg/kg was a predictor of symptomatic intracerebral hemorrhage (P=0.0109), and a dose ≤0.65 mg/kg was a predictor of good functional outcome (P=0.0369). In patients aged 71 to 80 years, there was a significant trend of increasing symptomatic intracerebral hemorrhage (P=0.0130) and less good functional outcome (P=0.0179) with increasing doses of r-tPA. There was also a trend of increasing mortality (P=0.0971) at 3 months in these patients. CONCLUSIONS - : These results did not support the dose of 0.9 mg/kg of r-tPA being optimal for all patients in the East Asian population. In elderly patients (71-80 years), a lower dose of 0.6 mg/kg is associated with a better outcome. Confirmation of the results through randomized trial is required.

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