https://scholars.lib.ntu.edu.tw/handle/123456789/590503
標題: | Different doses of recombinant tissue-type plasminogen activator for acute stroke in Chinese patients | 作者: | Chao A.-C. Liu C.-K. Chen C.-H. Lin H.-J. Liu C.-H. JIANN-SHING JENG Hu C.-J. Chung C.-P. Hsu H.-Y. Sheng W.-Y. Hu H.-H. |
公開日期: | 2014 | 卷: | 45 | 期: | 8 | 起(迄)頁: | 2359-2365 | 來源出版物: | Stroke | 摘要: | BACKGROUND AND PURPOSE - : The relationship between the dose of recombinant tissue-type plasminogen activator (r-tPA) and its safety/efficacy for ischemic stroke has not been well evaluated in the East Asian population. We assessed the safety/efficacy of different doses of r-tPA for acute ischemic stroke in Chinese patients. METHODS - : A total of 1004 eligible patients were classified according to the dose of r-tPA received for managing acute ischemic stroke: 0.9 mg/kg (n=422), 0.8 mg/kg (n=202), 0.7 mg/kg (n=199), and 0.6 mg/kg (n=181). The safety outcome was symptomatic intracerebral hemorrhage and death within 3 months. The efficacy outcome was good functional outcome (modified Rankin Scale ?1) at 3 months. RESULTS - : There was a significant trend for symptomatic intracerebral hemorrhage with age (P=0.002). With multivariate logistic regression analysis, a dose of 0.9 mg/kg was a predictor of symptomatic intracerebral hemorrhage (P=0.0109), and a dose ?0.65 mg/kg was a predictor of good functional outcome (P=0.0369). In patients aged 71 to 80 years, there was a significant trend of increasing symptomatic intracerebral hemorrhage (P=0.0130) and less good functional outcome (P=0.0179) with increasing doses of r-tPA. There was also a trend of increasing mortality (P=0.0971) at 3 months in these patients. CONCLUSIONS - : These results did not support the dose of 0.9 mg/kg of r-tPA being optimal for all patients in the East Asian population. In elderly patients (71-80 years), a lower dose of 0.6 mg/kg is associated with a better outcome. Confirmation of the results through randomized trial is required. ? 2014 American Heart Association, Inc.. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84905961049&doi=10.1161%2fSTROKEAHA.114.005245&partnerID=40&md5=e1bd12424efc1aae9733dd28cb99904a https://scholars.lib.ntu.edu.tw/handle/123456789/590503 |
ISSN: | 392499 | DOI: | 10.1161/STROKEAHA.114.005245 | SDG/關鍵字: | alteplase; age; aged; article; brain hemorrhage; cerebrovascular accident; Chinese; dose response; drug dose comparison; drug dose increase; drug efficacy; drug safety; female; human; major clinical study; male; mortality; priority journal; Rankin scale; stroke patient; treatment outcome; cerebral hemorrhage; stroke; Aged; Aged, 80 and over; Asian Continental Ancestry Group; Brain Ischemia; Dose-Response Relationship, Drug; Female; Fibrinolytic Agents; Humans; Infusions, Intravenous; Male; Middle Aged; Prospective Studies; Stroke; Thrombolytic Therapy; Time Factors; Tissue Plasminogen Activator; Treatment Outcome |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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