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Current status of intravenous tissue plasminogen activator dosage for acute ischaemic stroke: An updated systematic review

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收录情况： ◇ SCIE

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机构： [1]The George Institute for Global Health, Newtown, New South Wales, Australia [2]Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia [3]Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China [4]Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan [5]Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China [6]Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia [7]The George Institute China, Peking University Health Science Center, Beijing, China [8]Department of Neurology, Oslo University Hospital, Oslo, Norway [9]Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases, University of Leicester, Leicester, UK [10]Yong Loo Lin School of Medicine, National University of Singapore, Singapore [11]Division of Neurology, National University Hospital, Singapore

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The optimal dose of recombinant tissue plasminogen activator (rtPA) for acute ischaemic stroke (AIS) remains controversial, especially in Asian countries. We aimed to update the evidence regarding the use of low-dose versus standard-dose rtPA. We performed a systematic literature search across MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to 22 August 2016 to identify all related studies. The outcomes were death or disability (defined by modified Rankin Scale 2-6), death, and symptomatic intracerebral haemorrhage (sICH). Where possible, data were pooled for meta-analysis with ORs and corresponding 95% CIs by means of random-effects or fixed-effects meta-analysis. We included 26 observational studies and 1 randomised controlled trial with a total of 23 210 patients. Variable doses of rtPA were used for thrombolysis of AIS in Asia. Meta-analysis shows that low-dose rtPA was not associated with increased risk of death or disability (OR 1.13, 95% CI 0.95 to 1.33), or death (OR 0.86, 95% CI 0.74 to 1.01), or decreased risk of sICH (OR 1.06, 95% CI 0.65 to 1.72). The results remained consistent when sensitivity analyses were performed including only low-dose and standard-dose rtPA or only Asian studies. Our review shows small difference between the outcomes or the risk profile in the studies using low-dose and/or standard-dose rtPA for AIS. Low-dose rtPA was not associated with lower risk of death or disability, death alone, or sICH. © 2018 Stroke and Vascular Neurology. All rights reserved.

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大类 | 1 区医学

小类 | 2 区临床神经病学

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最新[2023]版：

Q1 CLINICAL NEUROLOGY

影响因子： 4.4 最新[2023版] 6 最新五年平均 0 出版当年[2016版] 0 出版当年五年平均 0 出版前一年[2015版]

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第一作者机构： [1]The George Institute for Global Health, Newtown, New South Wales, Australia [2]Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia

通讯作者：

通讯机构： [5]Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China

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