Thrombolytic therapy in acute ischemic stroke in Asia: The first prospective evaluation

Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre

“…9 In 3 studies from developing countries the mortality at discharge ranged from 0 to 5.9%. 13,14,16 It is estimated that <2% of patients with ischaemic stroke in our hospital drainage area received thrombolysis, which seems comparable with data from other developing countries. 15,16 However, our reported thrombolysis rate is an overestimation for the general population, as most patients with acute stroke are managed conservatively at lower level facilities where thrombolysis is not available.…”

“…6 Smaller studies from other developing countries reported similar results. [13][14][15][16][17] The European Medicines Evaluation Agency allowed registration of tPA for acute stroke in 2002, on condition that an observational safety study be performed to address concerns about the applicability of data from randomised controlled trials to individuals in daily clinical practice. At 3-month followup, 54.8% of patients in this SITS-MOST cohort were functionally independent, 7 compared with 40.5% at the time of discharge in our study.…”

“…9 Pooled data from five observational studies from developing countries show a lower proportion of patients suffering SICH, 9/293 (3.1%), but the rates ranged from 0 to 5.9% between the different centres. [13][14][15][16][17] Although the number is small and does not represent a significant association, all three of our patients over the age of 75 had bleeding complications. Studies in the developed world support the safety of tPA in patients over 80 years.…”

“…However, there is growing evidence of of its comparable efficacy and safety when used in these settings. [13][14][15][16][17] The new South African national stroke guidelines recommend tPA as treatment for acute ischaemic stroke within 4.5 hours of symptom onset. 18 However, there are no published data on the use of thrombolysis in Africa.…”

Progressive Ischemic Stroke: Clinical Features and Evaluation of Short-and Long- Term Tirofiban Therapy

“…The criteria for inclusion in the study were: presence of minor or medium-degree stroke on admission [with National Institute of Health Stroke Scale (NIHSS) score of [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], final diagnosis of PIS, age range of 18-80, contraindication for thrombolytic therapy, tirofiban use for therapy, and reachable control data at the end of the 3. month. The criteria for exclusion from the study were history of cerebral or extracerebral hemorrhage, known intracranial disease (such as arteriovenous malformation, neoplasm, aneurysm), liver disease, thrombocytopenia (platelet number <100.000), platelet dysfunction, major trauma, major surgery in the last 3 months, and past stroke; coagulopathy [prothrombin time (PT) >1.3 times of the normal and international normalized ratio (INR) >1.3].…”