Comparison of Effectiveness and Safety of Low- Dose Versus Standard-Dose Intravenous Recombinant Tissue Plasminogen Activator in Patients With Acute Ischemic Stroke: A Meta- Analysis

被引:2
作者
Karedath, Jithin [1 ]
Avanteeka, F. N. U. [2 ]
Aslam, Muhammad Nouman [3 ]
Nadeem, Ahmad [4 ]
Yousaf, Rao Ahmed [5 ]
Shah, Sandesh [6 ]
Palleti, Sujith K. [7 ,8 ]
Khan, Areeba [9 ]
机构
[1] Kings Coll Hosp NHS Fdn Trust, Internal Med, London, England
[2] Liaquat Univ Med & Hlth Sci, Internal Med, Jamshoro, Pakistan
[3] King Edwards Med Univ, Med Coll, Lahore, Pakistan
[4] Liaquat Natl Hosp, Med, Karachi, Pakistan
[5] Faisalabad Med Univ, Med Coll, Faisalabad, Pakistan
[6] KIST Med Coll, Dept Dermatol, Lalitpur, Nepal
[7] Edward Hines Jr VA Hosp, Nephrol, Hines, IL USA
[8] Loyola Univ, Nephrol, Med Ctr, Maywood, IL USA
[9] United Med & Dent Coll, Crit Care Med, Karachi, Pakistan
关键词
meta; -analysis; recombinant tissue plasminogen activator; standard dose; stroke; low dose; 0.6; MG/KG; THROMBOLYSIS; ALTEPLASE;
D O I
10.7759/cureus.35571
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of the present meta-analysis is to compare the efficacy and safety of low-dose and standard -dose recombinant tissue plasminogen activators (r-tPA) in patients with acute ischemic stroke. The present meta-analysis was conducted according to the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We conducted a systematic search in PubMed, Embase, and the Cochrane Library to identify studies published between January 1, 2010, and January 31, 2023, using the following terms: "stroke," "alteplase," "doses," "efficacy," "tissue plasminogen activator," "r-tPA," and "safety." Primary efficacy outcomes included favorable outcomes (Modified Rankin Scale scores of 0-2), while secondary efficacy outcome was all-cause mortality at 90 days. Safety outcomes included asymptomatic intracerebral hemorrhage (ICH) and symptomatic ICH assessed using the National Institute of Neurological Disorders and Stroke (NINDS) study and the Safe Implementation of Thrombolysis in Stroke-Monitoring (SITS-MOST) study. We also compared parenchymal hematomas as safety outcome between the two groups defined by the authors themselves in their research. A total of 16 studies were included in the present meta-analysis. The meta-analysis did not report any significant difference between low-dose and standard-dose r-tPA in terms of mortality, symptomatic intracranial hemorrhage (SICH), asymptomatic ICH, and parenchymal hematomas. However, the favorable outcome was significantly greater in patients receiving a standard dose of r-tPA.
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页数:10
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