To the Editor: I found it ironic to read the recent editorial by Davis and colleagues endorsing the use of tissue plasminogen activator (tPA) therapy for stroke patients.1 The irony relates to the fact that a week later I attended the annual scientific meeting of the Australasian College for Emergency Medicine, where data were presented (Hoffman J. New information on the use of tPA in acute ischaemic stroke. 24th Annual Scientific Meeting of the Australasian College for Emergency Medicine; 2007 Nov 25–30; Gold Coast, Qld) that cast strong doubt on the conclusions derived from the NINDS trial.2
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- Department of Emergency Medicine, Royal Perth Hospital and University of Western Australia, Perth, WA.
- 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. 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.
- 3. American Academy of Emergency Medicine. Position statement on the use of intravenous thrombolytic therapy in the treatment of stroke. Milwaukee, Wis: AAEM, 2002. http://www.aaem.org/positionstatements/thrombolytictherapy.php (accessed Feb 2008).