Further randomized controlled trials of tissue plasminogen activator within 3 hours are required.
نویسنده
چکیده
Why Are Stroke Physicians Uncertain of the Benefits of Early tPA? An independent national survey1 of 1716 stroke physicians in the United Kingdom reported that 74% were uncertain of the benefits of thrombolytic therapies. A recent United States survey2 reported that less than half of the responding neurologists had administered tPA and only 30% believed the efficacy of intravenous tPA was “very convincing.”
منابع مشابه
Pilot randomized trial of tissue plasminogen activator in acute ischemic stroke. The TPA Bridging Study Group.
BACKGROUND AND PURPOSE Early thrombolytic therapy with recombinant tissue-type plasminogen activator is a theoretically attractive approach to the treatment of acute focal cerebral ischemia. In preparation for a larger multicenter trial, three centers piloted a protocol for a randomized, double-blind, placebo-controlled trial of intravenous recombinant tissue-type plasminogen activator begun wi...
متن کاملThe ethics of thrombolytic trials beyond 3 (or 4.5) hours: randomized controlled trials are required to change clinical practice.
For several decades, clinicians across all fields of internal medicine have embraced the concept of practice guidelines based on levels of evidence. Medical practice in our careers has been transformed from opinion-driven behavior to a reliance on carefully assessed evidence, ranked according to its strength. Ultimately, we expect level 1 evidence for any new therapy, namely adequately powered ...
متن کاملPilot Randomized Trial of Tissue Plasminogen Activator in Acute Ischemic Stroke
Background and Purpose: Early thrombolytic therapy with recombinant tissue-type plasminogen activator is a theoretically attractive approach to the treatment of acute focal cerebral ischemia. In preparation for a larger multicenter trial, three centers piloted a protocol for a randomized, double-blind, placebo-controlled trial of intravenous recombinant tissue-type plasminogen activator begun w...
متن کاملIs it ethical to have a placebo arm in reperfusion trials in the 3- to 6-hour time window? Yes.
To date, no treatment has been proven to improve outcome when started 3 hours after the onset of acute ischemic stroke. Randomized placebo-controlled trials of new potential treatments are needed to: (1) determine if the treatment is effective; (2) determine if the treatment is effective in most patients or only in selected patients; and (3) determine, if only some patients benefit, the best wa...
متن کاملEffects of tissue-type plasminogen activator and anisoylated plasminogen streptokinase activator complex on mortality in acute myocardial infarction.
An overview of eight randomized controlled trials of tissue-type plasminogen activator (Alteplase or Duteplase) and 10 of anisoylated plasminogen streptokinase activator complex (Anistreplase) showed that the odds of early death were reduced by 29% by tissue-type plasminogen activator and 46% by anisoylated plasminogen streptokinase activator complex, with overlapping 95% confidence intervals. ...
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ورودعنوان ژورنال:
- Stroke
دوره 32 11 شماره
صفحات -
تاریخ انتشار 2001