Outcomes of thrombolytic therapy for acute ischemic stroke in Chinese patients: The Taiwan thrombolytic therapy for acute ischemic stroke (TTT-AIS) study

A. Ching Chao, Hung Yi Hsu, Chih Ping Chung, Chung Hsiang Liu, Chih Hung Chen, Michael Mu Huo Teng, Giia Sheun Peng, Wen Yung Sheng, Han Hwa Hu

研究成果: 雜誌貢獻文章同行評審

108 引文 斯高帕斯(Scopus)

摘要

BACKGROUND AND PURPOSE-: The safety and efficacy of alteplase for ischemic stroke has not been examined in Chinese patients. We assessed the safety and efficacy of alteplase for acute ischemic stroke in daily clinical practice in Taiwan. METHODS-: A prospective, multicenter, observational study was conducted in Taiwan from December 2004 to July 2008. Eligible patients (241) receiving alteplase were recruited and divided into 2 groups: standard dose (0.90±0.02 mg/kg, n=125) and lower dose (0.72±0.07 mg/kg, n=116). Primary outcome measures were safety: symptomatic intracerebral hemorrhage and death within 3 months. The secondary outcome measure was efficacy a modified Rankin scale of 0 to 2 after 3 months. RESULTS-: The standard-dose group had higher rates of symptomatic intracerebral hemorrhage using National Institute of Neurological Diseases and Stroke, European Cooperative Acute Stroke Study, and Safe Implementation of Thrombolysis in Stroke-Monitoring Study definitions (10.4% versus 5.2%, 8.0% versus 2.6%, and 5.6% versus 1.7%, respectively) and mortality within 3 months (12.8% versus 6.9%), twice that of the lower-dose group. This pattern was more prominent in older patients. Significantly higher rates of symptomatic intracerebral hemorrhage per European Cooperative Acute Stroke Study (15.4% versus 3.3%, P=0.0257) and mortality (21.1% versus 5.0%, P=0.0099) and significantly lower independence rate (32.6% versus 53.6%, P=0.0311) were observed among patients â‰170 years old receiving the standard dose than those receiving the lower dose. CONCLUSIONS-: This study suggests that the standard dose of 0.9 mg/kg alteplase may not be optimal for treating aged Chinese patients. However, the dose of recombinant tissue plasminogen activator for ischemic stroke in Chinese patients should be based on more broad and convincing evidences and randomized trials of lower versus higher doses are needed.
原文英語
頁(從 - 到)885-890
頁數6
期刊Stroke
41
發行號5
DOIs
出版狀態已發佈 - 五月 1 2010
對外發佈

ASJC Scopus subject areas

  • 神經病學(臨床)
  • 心臟病學與心血管醫學
  • 高級和專業護理

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