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Low-dose versus standard-dose alteplase in acute ischemic stroke in Asian stroke registries: an individual patient data pooling study

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收录情况： ◇ SCIE

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机构： [1]Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, Australia [2]Department of Cardiology, People’s Liberation Army General Hospital, Beijing, China [3]Department of Cardiology, Xinqiao Hospital, Third Military Medical University, Chongqing, China [4]Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK [5]The Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea [6]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [7]College of Medicine, University of Illinois, Peoria, IL, USA [8]Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan [9]Shenyang First People’s Hospital, Shenyang Medical College Affiliated Shenyang Brain Hospital, Shenyang Brain Institute, Shenyang Clinical Research Center for Neurological Disorders, Shenyang, China [10]Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan [11]Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan [12]Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan [13]Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan [14]Division of Neurology, National University Hospital, Singapore [15]Stroke Services, Department of Neurology, Jose R. Reyes Memorial Medical Center, Manila, Philippines [16]Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan [17]Department of Neurology, Huashan Hospital Affiliated to Fudan University, Shanghai, China [18]The George Institute China, Peking University Health Science Center, Beijing, China [19]Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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关键词： Acute ischemic stroke alteplase dose Asian individual patient analysis symptomatic intracranial hemorrhage thrombolysis

摘要：

Objective: To investigate the comparative efficacy and safety of the low-dose versus standard-dose alteplase using real-world acute stroke registry data from Asian countries. Methods: Individual participant data were obtained from nine acute stroke registries from China, Japan, Philippines, Singapore, South Korea, and Taiwan between 2005 and 2018. Inverse probability of treatment weight was used to remove baseline imbalances between those receiving low-dose versus standard-dose alteplase. The primary outcome was death or disability defined by modified Rankin Scale scores of 2 to 6 at 90 days. Secondary outcomes were symptomatic intracerebral hemorrhage and death. Generalized linear mixed models with the individual registry as a random intercept were performed to determine associations of treatment with low-dose alteplase and outcomes. Results: Of the 6250 patients (mean age 66 years, 36% women) included in these analyses, 1610 (24%) were treated with low-dose intravenous alteplase. Clinical outcomes for low-dose alteplase were not significantly different to those for standard-dose alteplase, adjusted odds ratios for death or disability: 1.00 (0.85–1.19) and symptomatic intracerebral hemorrhage 0.87 (0.63–1.19), except for lower death with borderline significance, 0.77 (0.59–1.01). Conclusions: The present analyses of real-world Asian acute stroke registry data suggest that low-dose intravenous alteplase has overall comparable efficacy for functional recovery and greater potential safety in terms of reduced mortality, to standard-dose alteplase for the treatment of acute ischemic stroke. © 2019 World Stroke Organization.

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出版当年[2018]版：

大类 | 2 区医学

小类 | 3 区临床神经病学 3 区外周血管病

最新[2025]版：

大类 | 2 区医学

小类 | 2 区临床神经病学 2 区外周血管病

JCR分区：

出版当年[2017]版：

Q1 PERIPHERAL VASCULAR DISEASE Q1 CLINICAL NEUROLOGY

最新[2023]版：

Q1 CLINICAL NEUROLOGY Q1 PERIPHERAL VASCULAR DISEASE

影响因子： 6.3 最新[2023版] 6.3 最新五年平均 3.859 出版当年[2017版] 3.827 出版当年五年平均 3.314 出版前一年[2016版] 4.466 出版后一年[2018版]

第一作者：

第一作者机构： [1]Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, Australia

通讯作者：

通讯机构： [1]Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, Australia [6]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [18]The George Institute China, Peking University Health Science Center, Beijing, China [*1]The George Institute for Global Health PO Box M201, Missenden Road, NSW 2050, AUSTRALIA. [*2]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantanxili, Dongcheng District, Beijing, China 100050.

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Low-dose versus standard-dose alteplase in acute ischemic stroke in Asian stroke registries: an individual patient data pooling study

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