Abstract
Background: Although intravenous tissue-type plasminogen activator (t-PA) at a standard dose of 0.9mgkg-1 is effective for patients with acute ischemic stroke, concerns have been raised regarding Asians. Objectives: To compare the safety and efficacy between low and standard doses for stroke thrombolysis. Patients/Methods: Consecutive patients receiving t-PA treatment were recruited according to the prespecified dosing policy from two medical centers in Taiwan: low dose (0.7mgkg-1) at National Cheng Kung University Hospital (NCKUH) from August 2006 to June 2009, or standard dose (0.9mgkg-1) at NCKUH from July 2009 to December 2010 and at Changhua Christian Hospital from May 2008 to December 2010. The primary safety outcome was the occurrence of symptomatic intracerebral hemorrhage (SICH). The secondary efficacy outcome was the proportion of patients with a modified Rankin Scale (mRS) grade of ≤1 at 3 months. Results: From August 2006 to December 2010, 261 patients were recruited, of whom 105 and 156 received low and standard doses, respectively. The occurrence of SICH was non-significantly lower in the standard-dose group than in the low-dose group (2.6% vs. 4.8%, respectively; P=0.34). The favorable outcome of mRS grade of ≤1 at 3 months was similar (38.4% and 41.1%, respectively; P=0.676). A review of other case series of low vs. standard doses in Asians also showed similar safety and efficacy. Conclusion: Our study, as well as other case series on Asians, revealed that standard-dose thrombolysis for acute ischemic stroke in an Asian population carries no increased risk of symptomatic intracerebral hemorrhage when compared with the low dose.
| Original language | English |
|---|---|
| Pages (from-to) | 1270-1275 |
| Number of pages | 6 |
| Journal | Journal of Thrombosis and Haemostasis |
| Volume | 10 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 2012 Jul 1 |
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All Science Journal Classification (ASJC) codes
- Hematology
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Optimal dose for stroke thrombolysis in Asians : Low dose may have similar safety and efficacy as standard dose. / Chen, C. H.; Hsieh, C. Y.; Lai, T. B.; Chuang, M. T.; Chen, W. L.; Sun, M. C.
In: Journal of Thrombosis and Haemostasis, Vol. 10, No. 7, 01.07.2012, p. 1270-1275.Research output: Contribution to journal › Article
TY - JOUR
T1 - Optimal dose for stroke thrombolysis in Asians
T2 - Low dose may have similar safety and efficacy as standard dose
AU - Chen, C. H.
AU - Hsieh, C. Y.
AU - Lai, T. B.
AU - Chuang, M. T.
AU - Chen, W. L.
AU - Sun, M. C.
PY - 2012/7/1
Y1 - 2012/7/1
N2 - Background: Although intravenous tissue-type plasminogen activator (t-PA) at a standard dose of 0.9mgkg-1 is effective for patients with acute ischemic stroke, concerns have been raised regarding Asians. Objectives: To compare the safety and efficacy between low and standard doses for stroke thrombolysis. Patients/Methods: Consecutive patients receiving t-PA treatment were recruited according to the prespecified dosing policy from two medical centers in Taiwan: low dose (0.7mgkg-1) at National Cheng Kung University Hospital (NCKUH) from August 2006 to June 2009, or standard dose (0.9mgkg-1) at NCKUH from July 2009 to December 2010 and at Changhua Christian Hospital from May 2008 to December 2010. The primary safety outcome was the occurrence of symptomatic intracerebral hemorrhage (SICH). The secondary efficacy outcome was the proportion of patients with a modified Rankin Scale (mRS) grade of ≤1 at 3 months. Results: From August 2006 to December 2010, 261 patients were recruited, of whom 105 and 156 received low and standard doses, respectively. The occurrence of SICH was non-significantly lower in the standard-dose group than in the low-dose group (2.6% vs. 4.8%, respectively; P=0.34). The favorable outcome of mRS grade of ≤1 at 3 months was similar (38.4% and 41.1%, respectively; P=0.676). A review of other case series of low vs. standard doses in Asians also showed similar safety and efficacy. Conclusion: Our study, as well as other case series on Asians, revealed that standard-dose thrombolysis for acute ischemic stroke in an Asian population carries no increased risk of symptomatic intracerebral hemorrhage when compared with the low dose.
AB - Background: Although intravenous tissue-type plasminogen activator (t-PA) at a standard dose of 0.9mgkg-1 is effective for patients with acute ischemic stroke, concerns have been raised regarding Asians. Objectives: To compare the safety and efficacy between low and standard doses for stroke thrombolysis. Patients/Methods: Consecutive patients receiving t-PA treatment were recruited according to the prespecified dosing policy from two medical centers in Taiwan: low dose (0.7mgkg-1) at National Cheng Kung University Hospital (NCKUH) from August 2006 to June 2009, or standard dose (0.9mgkg-1) at NCKUH from July 2009 to December 2010 and at Changhua Christian Hospital from May 2008 to December 2010. The primary safety outcome was the occurrence of symptomatic intracerebral hemorrhage (SICH). The secondary efficacy outcome was the proportion of patients with a modified Rankin Scale (mRS) grade of ≤1 at 3 months. Results: From August 2006 to December 2010, 261 patients were recruited, of whom 105 and 156 received low and standard doses, respectively. The occurrence of SICH was non-significantly lower in the standard-dose group than in the low-dose group (2.6% vs. 4.8%, respectively; P=0.34). The favorable outcome of mRS grade of ≤1 at 3 months was similar (38.4% and 41.1%, respectively; P=0.676). A review of other case series of low vs. standard doses in Asians also showed similar safety and efficacy. Conclusion: Our study, as well as other case series on Asians, revealed that standard-dose thrombolysis for acute ischemic stroke in an Asian population carries no increased risk of symptomatic intracerebral hemorrhage when compared with the low dose.
UR - http://www.scopus.com/inward/record.url?scp=84863479458&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863479458&partnerID=8YFLogxK
U2 - 10.1111/j.1538-7836.2012.04761.x
DO - 10.1111/j.1538-7836.2012.04761.x
M3 - Article
C2 - 22541172
AN - SCOPUS:84863479458
VL - 10
SP - 1270
EP - 1275
JO - Journal of Thrombosis and Haemostasis
JF - Journal of Thrombosis and Haemostasis
SN - 1538-7933
IS - 7
ER -