Systemic thrombolysis by alteplase for acute ischemic stroke

Darvesh N, Butcher R
Record ID 32018005182
English
Authors' objectives: The purpose of this Rapid Review is to summarize the evidence regarding the safety and effectiveness of alteplase administered within 3 hours and alteplase administered between 3 hours and 4.5 hours in adult patients with AIS.
Authors' results and conclusions: Evidence was summarized to determine the effect of alteplase in adult stroke patients. • There is substantial uncertainty concerning the evidence due to the risk of bias in the available studies and imprecision in how the magnitude of the treatment effects were estimated. • The identified research suggests that alteplase administered within 3 hours of a stroke might result in: ?fewer deaths after 18 months and little-to-no difference in death after 7 days, 3 months, 6 months, or 3 years, increased brain bleeds after 7 days but no difference after 36 hours or after 3 months, improvements in functioning and independence after 7 days and after 6 months; at 3 months, some studies showed no difference in independence and another study showed higher functioning. • The identified research suggests that alteplase administered between 3 hours and 4.5 hours after a stroke might result in: little-to-no difference in deaths after 3 months; at 7 days, some evidence showed little-to-no difference in death while other evidence suggested more deaths, little-to-no differences in brain bleeds after 36 hours; at 7 days, some evidence showed no effect on brain bleeds, while other evidence showed more brain bleeds, no differences in functioning and independence after 6 months; at 3 months, some evidence showed no effect on functioning, while other evidence reported improved functioning.
Details
Project Status: Completed
URL for project: https://www.cadth.ca/systemic-thrombolysis-alteplase-acute-ischemic-stroke
Year Published: 2022
URL for published report: https://www.cadth.ca/sites/default/files/pdf/htis/2022/RD0066%20Alteplase%20for%20acute%20ischemic%20stroke%20Final.pdf
English language abstract: An English language summary is available
Publication Type: Rapid Review
Country: Canada
MeSH Terms
  • Ischemic Stroke
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator
  • Fibrinolytic Agents
  • Stroke
Contact
Organisation Name: Canadian Agency for Drugs and Technologies in Health
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name: requests@cadth.ca
Contact Email: requests@cadth.ca
Copyright: <p>Canadian Agency for Drugs and Technologies in Health (CADTH)</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.