Journal article

Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials

Jonathan Emberson, Kennedy R Lees, Patrick Lyden, Lisa Blackwell, Gregory Albers, Erich Bluhmki, Thomas Brott, Geoff Cohen, Stephen Davis, Geoffrey Donnan, James Grotta, George Howard, Markku Kaste, Masatoshi Koga, Ruediger von Kummer, Maarten Lansberg, Richard I Lindley, Gordon Murray, Jean Marc Olivot, Mark Parsons Show all

LANCET | ELSEVIER SCIENCE INC | Published : 2014

Abstract

BACKGROUND: Alteplase is effective for treatment of acute ischaemic stroke but debate continues about its use after longer times since stroke onset, in older patients, and among patients who have had the least or most severe strokes. We assessed the role of these factors in affecting good stroke outcome in patients given alteplase. METHODS: We did a pre-specified meta-analysis of individual patient data from 6756 patients in nine randomised trials comparing alteplase with placebo or open control. We included all completed randomised phase 3 trials of intravenous alteplase for treatment of acute ischaemic stroke for which data were available. Retrospective checks confirmed that no eligible tr..

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