Tissue plasminogen activator for acute ischaemic stroke

Toncich, Gino J

doi:10.5694/j.1326-5377.2008.tb01730.x

Topics

To the Editor: The assertion of Davis and Batmanian and their colleagues that thrombolytic treatment for ischaemic stroke is reasonably safe and highly effective1,2 is not supported by the primary randomised trials of its use.3

Emergency Department, Royal Melbourne Hospital, Melbourne, VIC.

Correspondence: gino.toncich@mh.org.au

1. Davis SM, Hand PJ, Donnan GA. Tissue plasminogen activator for ischaemic stroke: highly effective, reasonably safe and grossly underused [editorial]. Med J Aust 2007; 187: 548-549. <MJA full text>
2. Batmanian JJ, Lam M, Matthews C, et al. A protocol-driven model for the rapid initiation of stroke thrombolysis in the emergency department. Med J Aust 2007; 187: 567-570. <MJA full text>
3. Hoffman JR. Tissue plasminogen activator (tPA) for acute ischaemic stroke: why so much has been made of so little [editorial]. Med J Aust 2003; 179: 333-334. <MJA full text>
4. Hacke W, Donnan G, Fieschi C, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS and NINDS rt-PA stroke trials. Lancet 2004; 363: 768-774.
5. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N Engl J Med 1995; 333: 1581-1587.
6. Bateman BT, Schumacher HC, Boden-Albala B, et al. Factors associated with in-hospital mortality after administration of thrombolysis in acute ischemic stroke patients: an analysis of the Nationwide Inpatient Sample 1999 to 2002. Stroke 2006; 37: 440-446.
7. Schumacher HC, Bateman BT, Boden-Albala B, et al. Use of thrombolysis in acute ischemic stroke: analysis of the Nationwide Inpatient Sample 1999 to 2004. Ann Emerg Med 2007; 50: 99-107.

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