TIME TO TREATMENT WITH INTRAVENOUS TIS- SUE PLASMINOGEN ACTIVATOR AND OUTCOME FROM ACUTE ISCHEMIC STROKE. Saver J, Fonarow G, Smith E, et al. JAMA 2013;309:2480-8.

摘要

Typically limited to a usage window of 4.5 h after onset of symptotissue-type plasminogen activator (tPA) has proven to be beneficial in the treatment of acute stroke.This study aimed to assess the extent to which onset to treatment time (OTT), influenced overall outcome. There were 58,353 patients who received tPA for acute stroke included in the study and placed into three sub-groups: OTT of 0-90 min (5404 patients), 91-190 min (45,029 patients), and 181-270 minutes (7920 patients).Data showed that improved outcomes were independently linked to OTT. For every 15-min-faster interval of treatment, mortality was less likely to occur (odds ratio [OR], 0.96; 95% confidence interval [CI] 0.95-0.98); symptomatic intracranial hemorrhage was less likely to occur (OR 0.96; 95% CI 0.95-0.98); independence in ambulation at discharge was more likely to occur (OR 1.04; 95% CI 1.03-1.05), and discharge to home was more likely to occur (OR 1.03; 95% CI 1.02-1.04).