Bin Qin1, Ming-Jun Zhao2, Hong Chen1, Huixun Qin1, Libo Zhao3, Lin Fu1, Cheng Qin1, Mingxiu Yang1, Wen Gao4. 1. Department of Neurology, Affiliated Liuzhou People's Hospital of Guangxi University of Science and Technology (Liuzhou People's Hospital), Liuzhou, Guangxi, China. 2. Department of Pharmacy, The Second Affiliated Hospital of Xinxiang Medical University (Henan Mental Hospital), Xinxiang, China. 3. Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China. 4. Department of Neurology, Affiliated Liuzhou People's Hospital of Guangxi University of Science and Technology (Liuzhou People's Hospital), Liuzhou, Guangxi, China. Electronic address: lzrmyygw@126.com.
Abstract
BACKGROUND: Evidence from outside the typical clinical research setting, such as the real-world setting, complements evidence coming from randomized controlled trials. The purpose of this study was to evaluate all available evidence from the real-world observational trials about long-term outcomes of treatment with intravenous (IV) recombinant tissue-type plasminogen activator (rt-PA) compared with not treated with IV rt-PA (non-rt-PA) in patients with acute ischemic stroke. METHODS: We searched PubMed and Embase until March 1, 2018 for observational studies reporting matched or adjusted results comparing IV rt-PA versus non-rt-PA in patients with acute ischemic stroke. Outcomes assessed included all-cause mortality, hospital readmission rates, and independence rates. Hazard ratios with 95% confidence intervals were used as a measure of comparing between patients treated with IV rt-PA and non-rt-PA. RESULTS: Six observational trials with 16,399 participants were identified. The use of IV rt-PA in acute ischemic stroke patients was associated with a lower risk of mortality (hazard ratio .61; 95% confidence interval, .52-.70; P < .00001), and there was no heterogeneity across trials. There was no evidence of an effect on hospital readmission rates and independence rates. CONCLUSIONS: IV rt-PA is associated with reduced long-term mortality in acute ischemic stroke patients.
BACKGROUND: Evidence from outside the typical clinical research setting, such as the real-world setting, complements evidence coming from randomized controlled trials. The purpose of this study was to evaluate all available evidence from the real-world observational trials about long-term outcomes of treatment with intravenous (IV) recombinant tissue-type plasminogen activator (rt-PA) compared with not treated with IV rt-PA (non-rt-PA) in patients with acute ischemic stroke. METHODS: We searched PubMed and Embase until March 1, 2018 for observational studies reporting matched or adjusted results comparing IV rt-PA versus non-rt-PA in patients with acute ischemic stroke. Outcomes assessed included all-cause mortality, hospital readmission rates, and independence rates. Hazard ratios with 95% confidence intervals were used as a measure of comparing between patients treated with IV rt-PA and non-rt-PA. RESULTS: Six observational trials with 16,399 participants were identified. The use of IV rt-PA in acute ischemic strokepatients was associated with a lower risk of mortality (hazard ratio .61; 95% confidence interval, .52-.70; P < .00001), and there was no heterogeneity across trials. There was no evidence of an effect on hospital readmission rates and independence rates. CONCLUSIONS: IV rt-PA is associated with reduced long-term mortality in acute ischemic strokepatients.
Authors: Verónica V Olavarría; Lorena Hoffmeister; Carolina Vidal; Alejandro M Brunser; Arnold Hoppe; Pablo M Lavados Journal: Front Neurol Date: 2022-04-08 Impact factor: 4.086