Protocol Violations in Community-Based rTPA Stroke Treatment Are Associated With Symptomatic Intracerebral Hemorrhage

Lopez-Yunez, Alfredo M.; Bruno, Askiel; Williams, Linda S.; Yilmaz, Engin Y.; Zurrú, Cristina; Biller, José

doi:10.1161/01.str.32.1.12

Cited by 129 publications

(100 citation statements)

References 26 publications

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“…66,262,265,266 Failure to meet the blood pressure parameters of previous guidelines may be one of the explanations for an increased risk of hemorrhagic complications after administration of rtPA. [267][268][269] Presumably, similar risks of bleeding will be associated with elevations of blood pressure among patients receiving other acute pharmacological or mechanical interventions to improve the perfusion to the brain. The suggestion to withhold such therapies among patients with markedly elevated blood pressure is based on potential safety risks.…”

Section: Arterial Hypertensionmentioning

confidence: 99%

Guidelines for the Early Management of Adults With Ischemic Stroke

Adams

Zoppo²,

Alberts

et al. 2007

Stroke

2,123

483

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Purpose-Our goal is to provide an overview of the current evidence about components of the evaluation and treatment of adults with acute ischemic stroke. The intended audience is physicians and other emergency healthcare providers who treat patients within the first 48 hours after stroke. In addition, information for healthcare policy makers is included. Methods-Members of the panel were appointed

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Section: Arterial Hypertensionmentioning

confidence: 99%

Guidelines for the Early Management of Adults With Ischemic Stroke

Adams

Zoppo²,

Alberts

et al. 2007

Stroke

2,123

483

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“…A combined 115 warfarin-treated stroke patients with INR >1.7 at the time of intravenous alteplase administration have been reported in the English literature, derived from large registries and a few small case series. 52,111,155,[157][158][159][160][161] (Table 13) Of these, sICH was reported in only 1 patient. Most studies did not provide information about the rates of all types of ICH or functional outcomes in these small subsets of patients.…”

Section: Abnormal Coagulation Valuesmentioning

confidence: 99%

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

Demaerschalk¹,

Kleindorfer²,

Adeoye³

et al. 2016

Stroke

585

237

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Purpose-To critically review and evaluate the science behind individual eligibility criteria (indication/inclusion and contraindications/exclusion criteria) for intravenous recombinant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow us to better inform stroke providers of quantitative and qualitative risks associated with alteplase administration under selected commonly and uncommonly encountered clinical circumstances and to identify future research priorities concerning these eligibility criteria, which could potentially expand the safe and judicious use of alteplase and improve outcomes after stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge and, when appropriate, formulated recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on and approved the final version of this document. The document underwent extensive American Heart Association internal peer review, Stroke The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on September 24, 2015, and the American Heart Association Executive Committee on October 5, 2015. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@ wolterskluwer.com.The online-only Data Supplement, which contains literature search strategies and Figures A, B, and C, is available with this article at http://circ. ahajournals.org/lookup/suppl/doi:10.1161/STR.0000000000000086/-/DC1.The American Heart Association requests that this document be cited as follows: Demaerschalk BM, Kleindorfer DO, Adeoye OM, Demchuk AM, Fugate JE, Grotta JC, Khalessi AA, Levy EI, Palesch YY, Prabhakaran S, Saposnik G, Saver JL, Smith EE; on behalf of the American Heart Association Stroke Council and Council on Epidemiology and Prevention. Scientific rational...

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“…3), and was similar to rates in other reported series. [26][27][28][29][30][31][32][33][34][35][36] Serious adverse events occurred in 75 (6.6%) of the patients (95% CI 5.2%-8.2%) ( Table 3). Of the 52 (4.6%) who had a symptomatic intracranial hemorrhage, 39 (75%) died in hospital.…”

Section: Resultsmentioning

confidence: 99%