English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Objective To evaluate the efficacy and safety of thrombolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) in the treatment of acute ischemic stroke with broadened therapeutic window (4.50-6.00 h).  Methods Online databases, such as PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang data were searched from January 1980 to August 2015 with key words: acute ischemic stroke, thrombolytic therapy, beyond 4.5 hours. The included studies were evaluated according to Jadad Scale, and Meta-analysis was performed by using RevMan 5.3 software.  Results There were 681 relevant records through preliminary searching, and 3 randomized controlled trials (RCTs) were finally included, involving 2033 patients with acute ischemic stroke (1029 patients in rt-PA thrombolytic therapy and 1004 patients in placebo therapy), who were treated within 6 h from the onset of symptoms. Results of Meta-analysis showed there were no statistical differences between rt-PA group and placebo group on modified Rankin Scale (mRS) score ( RR = 1.070, 95%CI: 0.940-1.220; P = 0.310), Barthel Index (BI) score ( RR = 1.040, 95%CI: 0.940-1.160; P = 0.430) and mortality ( RR = 1.260, 95%CI: 0.990-1.610; P = 0.060). However, the incidence of intracerebral hemorrhage (ICH) in rt-PA group was significantly higher than that in placebo group ( RR = 1.550, 95% CI: 1.030-2.340; P = 0.030).  Conclusions Thrombolytic therapy with rt-PA in broadened therapeutic window (4.50-6.00 h) is not effective for treating acute ischemic stroke, and the risk of ICH is increased with rt-PA treatment. However, this conclusion still needs to be verified with more high-quality, multi-center, large-sample RCTs. DOI: 10.3969/j.issn.1672-6731.2016.02.002

Efficacy and safety of rt-PA intravenous thrombolysis for treating acute ischemic stroke beyond the therapeutic window: a Meta-analysis