Low-Versus Standard-Dose Alteplase for Ischemic Strokes Within 4.5 Hours A Comparative Effectiveness and Safety Study
DC Field | Value | Language |
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dc.contributor.author | Kim, Beom Joon | - |
dc.contributor.author | Han, Moon-Ku | - |
dc.contributor.author | Park, Tai Hwan | - |
dc.contributor.author | Park, Sang-Soon | - |
dc.contributor.author | Lee, Kyung Bok | - |
dc.contributor.author | Lee, Byung-Chul | - |
dc.contributor.author | Yu, Kyung-Ho | - |
dc.contributor.author | Oh, Mi Sun | - |
dc.contributor.author | Cha, Jae Kwan | - |
dc.contributor.author | Kim, Dae-Hyun | - |
dc.contributor.author | Lee, Jun | - |
dc.contributor.author | Lee, Soo Joo | - |
dc.contributor.author | Ko, Youngchai | - |
dc.contributor.author | Park, Jong-Moo | - |
dc.contributor.author | Kang, Kyusik | - |
dc.contributor.author | Cho, Yong-Jin | - |
dc.contributor.author | Hong, Keun-Sik | - |
dc.contributor.author | Kim, Joon-Tae | - |
dc.contributor.author | Choi, Jay Chol | - |
dc.contributor.author | Kim, Dong-Eog | - |
dc.contributor.author | Shin, Dong-Ick | - |
dc.contributor.author | Kim, Wook-Joo | - |
dc.contributor.author | Lee, Juneyoung | - |
dc.contributor.author | Lee, Ji Sung | - |
dc.contributor.author | Yoon, Byung-Woo | - |
dc.contributor.author | Gorelick, Philip B. | - |
dc.contributor.author | Bae, Hee-Joon | - |
dc.date.accessioned | 2021-09-04T13:12:20Z | - |
dc.date.available | 2021-09-04T13:12:20Z | - |
dc.date.created | 2021-06-18 | - |
dc.date.issued | 2015-09 | - |
dc.identifier.issn | 0039-2499 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/92663 | - |
dc.description.abstract | Background 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.language | English | - |
dc.language.iso | en | - |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | - |
dc.subject | TISSUE-PLASMINOGEN ACTIVATOR | - |
dc.subject | MG/KG INTRAVENOUS ALTEPLASE | - |
dc.subject | MARGINAL STRUCTURAL MODELS | - |
dc.subject | PROPENSITY SCORE | - |
dc.subject | CHINESE PATIENTS | - |
dc.subject | RT-PA | - |
dc.subject | J-ACT | - |
dc.subject | THROMBOLYSIS | - |
dc.subject | TRIAL | - |
dc.subject | REGISTRY | - |
dc.title | Low-Versus Standard-Dose Alteplase for Ischemic Strokes Within 4.5 Hours A Comparative Effectiveness and Safety Study | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Lee, Juneyoung | - |
dc.identifier.doi | 10.1161/STROKEAHA.115.010180 | - |
dc.identifier.scopusid | 2-s2.0-84940398535 | - |
dc.identifier.wosid | 000360919700035 | - |
dc.identifier.bibliographicCitation | STROKE, v.46, no.9, pp.2541 - 2548 | - |
dc.relation.isPartOf | STROKE | - |
dc.citation.title | STROKE | - |
dc.citation.volume | 46 | - |
dc.citation.number | 9 | - |
dc.citation.startPage | 2541 | - |
dc.citation.endPage | 2548 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Neurosciences & Neurology | - |
dc.relation.journalResearchArea | Cardiovascular System & Cardiology | - |
dc.relation.journalWebOfScienceCategory | Clinical Neurology | - |
dc.relation.journalWebOfScienceCategory | Peripheral Vascular Disease | - |
dc.subject.keywordPlus | TISSUE-PLASMINOGEN ACTIVATOR | - |
dc.subject.keywordPlus | MG/KG INTRAVENOUS ALTEPLASE | - |
dc.subject.keywordPlus | MARGINAL STRUCTURAL MODELS | - |
dc.subject.keywordPlus | PROPENSITY SCORE | - |
dc.subject.keywordPlus | CHINESE PATIENTS | - |
dc.subject.keywordPlus | RT-PA | - |
dc.subject.keywordPlus | J-ACT | - |
dc.subject.keywordPlus | THROMBOLYSIS | - |
dc.subject.keywordPlus | TRIAL | - |
dc.subject.keywordPlus | REGISTRY | - |
dc.subject.keywordAuthor | acute ischemic stroke | - |
dc.subject.keywordAuthor | hemorrhage | - |
dc.subject.keywordAuthor | low-dose tPA | - |
dc.subject.keywordAuthor | thrombolysis | - |
dc.subject.keywordAuthor | tissue-type plasminogen activator | - |
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