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Low-versus standard-dose alteplase for ischemic strokes within 4.5 hours a comparative effectiveness and safety study

DC Field Value Language
dc.contributor.authorKim, Beom Joon-
dc.contributor.authorHan, Moon-Ku-
dc.contributor.authorPark, Tai Hwan-
dc.contributor.authorPark, Sang-Soon-
dc.contributor.authorLee, Kyung Bok-
dc.contributor.authorLee, Byung-Chul-
dc.contributor.authorYu, Kyung-Ho-
dc.contributor.authorOh, Mi Sun-
dc.contributor.authorCha, Jae Kwan-
dc.contributor.authorKim, Dae-Hyun-
dc.contributor.authorLee, Jun-
dc.contributor.authorLee, Soo Joo-
dc.contributor.authorKo, Youngchai-
dc.contributor.authorPark, Jong-Moo-
dc.contributor.authorKang, Kyusik-
dc.contributor.authorCho, Yong-Jin-
dc.contributor.authorHong, Keun-Sik-
dc.contributor.authorKim, Joon-Tae-
dc.contributor.authorChoi, Jay Chol-
dc.contributor.authorKim, Dong-Eog-
dc.contributor.authorShin, Dong-Ick-
dc.contributor.authorKim, Wook-Joo-
dc.contributor.authorLee, Juneyoung-
dc.contributor.authorLee, Ji Sung-
dc.contributor.authorYoon, Byung-Woo-
dc.contributor.authorGorelick, Philip B.-
dc.contributor.authorBae, Hee-Joon-
dc.date.accessioned2024-08-08T01:38:43Z-
dc.date.available2024-08-08T01:38:43Z-
dc.date.created2018-10-31-
dc.date.created2018-10-31-
dc.date.issued2015-09-
dc.identifier.citationStroke, Vol.46 No.9, pp.2541-2548-
dc.identifier.issn0039-2499-
dc.identifier.urihttps://hdl.handle.net/10371/207138-
dc.description.abstractBackground and Purpose-The low-dose (0.6 mg/kg) alteplase strategy to treat acute ischemic stroke patients became widespread in East Asian countries, without rigorous testing against standard-dose (0.9 mg/kg) alteplase treatment. Our aim was to investigate the comparative effectiveness and safety of the low-dose versus standard-dose intravenous alteplase strategy. Methods-A total of 1526 acute ischemic stroke patients who qualified for intravenous alteplase and treated within 4.5 hours were identified from a prospective, multicenter, and nationwide stroke registry database. Primary outcomes were a modified Rankin scale score of 0 to 1 at 3 months after stroke and occurrence of symptomatic hemorrhagic transformation. Inverse probability of low-dose alteplase weighting by propensity scores was used to remove baseline imbalances between the 2 groups, and variation among centers were also accounted using generalized linear mixed models with a random intercept. Results-Low-dose intravenous alteplase was given to 450 patients (29.5%) and standard-dose intravenous alteplase to 1076 patients (70.5%). Low-dose alteplase treatment was comparable to standard-dose therapy according to the following adjusted outcomes and odds ratios (95% confidence intervals): modified Rankin scale score 0 to 1 at 3 months and 0.95 (0.68-1.32); modified Rankin scale 0 to 2 at 3 months and 0.84 (0.62-1.15); symptomatic hemorrhagic transformation and 1.05 (0.65-1.70); and 3-month mortality and 0.54 (0.35-0.83). The associations were unchanged when the analysis was limited to those without endovascular recanalization. Conclusions-The low-dose alteplase strategy was comparable to the standard-dose treatment in terms of the effectiveness and safety.-
dc.language영어-
dc.publisherLippincott Williams & Wilkins Ltd.-
dc.titleLow-versus standard-dose alteplase for ischemic strokes within 4.5 hours a comparative effectiveness and safety study-
dc.typeArticle-
dc.identifier.doi10.1161/STROKEAHA.115.010180-
dc.citation.journaltitleStroke-
dc.identifier.wosid000360919700035-
dc.identifier.scopusid2-s2.0-84940398535-
dc.citation.endpage2548-
dc.citation.number9-
dc.citation.startpage2541-
dc.citation.volume46-
dc.description.isOpenAccessN-
dc.contributor.affiliatedAuthorHan, Moon-Ku-
dc.contributor.affiliatedAuthorYoon, Byung-Woo-
dc.contributor.affiliatedAuthorBae, Hee-Joon-
dc.type.docTypeArticle-
dc.description.journalClass1-
dc.subject.keywordPlusTISSUE-PLASMINOGEN ACTIVATOR-
dc.subject.keywordPlusMG/KG INTRAVENOUS ALTEPLASE-
dc.subject.keywordPlusMARGINAL STRUCTURAL MODELS-
dc.subject.keywordPlusPROPENSITY SCORE-
dc.subject.keywordPlusCHINESE PATIENTS-
dc.subject.keywordPlusRT-PA-
dc.subject.keywordPlusJ-ACT-
dc.subject.keywordPlusTHROMBOLYSIS-
dc.subject.keywordPlusTRIAL-
dc.subject.keywordPlusREGISTRY-
dc.subject.keywordAuthoracute ischemic stroke-
dc.subject.keywordAuthorhemorrhage-
dc.subject.keywordAuthorlow-dose tPA-
dc.subject.keywordAuthorthrombolysis-
dc.subject.keywordAuthortissue-type plasminogen activator-
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  • Department of Medicine
Research Area 뇌경색, 뇌졸중, 혈관성 인지장애 및 치매

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