Implementation and outcome of thrombolysis with alteplase 3-4.5 h after an acute stroke: an updated analysis from SITS-ISTR
Niaz Ahmed, Nils Wahlgren, Martin Grond, Michael Hennerici, Kennedy R Lees, Robert Mikulik, Mark Parsons, Risto O Roine, Danilo Toni, Peter Ringleb
LANCET NEUROLOGY | ELSEVIER SCIENCE INC | Published : 2010
Boehringer Ingelheim, Ferrer, the European Union Public Health Executive Authority, and Medical Training and Research (ALF) from Stockholm County Council and Karolinska Institutet.NA is an employee of SITS International, which received a grant from Boehringer Ingelheim and Ferrer for the SITS-MOST and SITS-ISTR. NW has received expenses from Boehringer Ingelheim for his role as member of the steering committee of the ECASS III trial, has served as a consultant to Thrombogenics as chairman of the data safety monitoring board, and has received lecture fees from Boehringer Ingelheim and Ferrer. SITS International (chaired by NW) received grants from Boehringer Ingelheim and Ferrer for SITS-MOST and SITS-ISTR. NW's institution has also received grant support towards administrative expenses for coordination of the ECASS III trial. KRL has received fees and expenses from Boehringer Ingelheim for his role as chairman of the independent data safety monitoring board of the ECASS III trial and related lectures, and has received fees from Paion, Forest, and Lundbeck for the trials of desmoteplase in acute ischaemic stroke. KRL's institute has received grant assistance towards administrative expenses for coordination of SITS in the UK. DT has served as a consultant for Boehringer Ingelheim and has received lecture fees for attending and speaking at workshops held by Boehringer Ingelheim, Sanofi-Aventis, and Novo Nordisk. PR has received honoraria and payment for manuscript preparation from Boehringer Ingelheim and PAION; and travel or accommodation expenses from Boehringer Ingelhei, Sanofi, PAION, Ferrer, and Lilly. All other authors have no conflicts of interest.SITS-ISTR is funded by an unrestricted grant from Boehringer Ingelheim, Ferrer, and by a grant from the European Union Public Health Executive Authority. Financial support was also provided through the regional agreement on medical training and research (ALF) between Stockholm County Council and Karolinska Institutet. J Tyler received funding from Boehringer Ingelheim to provide editorial assistance in the coordination of the submission. The views expressed are those of the authors. Uppsala Clinical Research (UCR) centre, Sweden, develops, maintains, and upgrades the software for the SITS register in close collaboration with SITS. UCR team members are Soren Gustavsson, Botond Pakucs, Olof Felton, and Niclas Eriksson. Alteplase (recombinant tissue plasminogen activator) is not approved in the USA or Europe for routine use in acute ischaemic stroke when initiated beyond 3 h from symptom onset. We thank all the SITS-ISTR investigators and their centres for their participation. We also thank all patients who participated in SITS-ISTR.