Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, September 2, 2016

Low-Versus Standard-Dose Alteplase for Ischemic Strokes Within 4.5 Hours: A Comparative Effectiveness and Safety Study

So comparative effectiveness and safety for this low dose one still means it is a complete fucking failure at 12% full recovery rate. Do people not even understand that there is a problem to be solved here?  Status quo is a failure. Fix that!!!
http://www.ncbi.nlm.nih.gov/pubmed/26243232
Kim BJ1, Han MK1, Park TH1, Park SS1, Lee KB1, Lee BC1, Yu KH1, Oh MS1, Cha JK1, Kim DH1, Lee J1, Lee SJ1, Ko Y1, Park JM1, Kang K1, Cho YJ1, Hong KS1, Kim JT1, Choi JC1, Kim DE1, Shin DI1, Kim WJ1, Lee J1, Lee JS1, Yoon BW1, Gorelick PB1, Bae HJ1.

Author information

Erratum in

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.
© 2015 American Heart Association, Inc.

KEYWORDS:

acute ischemic stroke; hemorrhage; low-dose tPA; thrombolysis; tissue-type plasminogen activator
PMID:
26243232
DOI:
10.1161/STROKEAHA.115.010180
[PubMed - indexed for MEDLINE]
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