Tissue plasminogen activator (tPA) in acute ischaemic stroke: Time for collegiate communication and consensus

Christopher R. Levi, David J. Blacker, Christopher F. Bladin, Peters M. Boers, Brian R. Chambers, Laurence L. Chu, Alastair J. Corbett, Denis S. Crimmins, Stephen M. Davis, Geoffrey A. Donnan, David W. Dunbabin, John N. Fink, Judith H. Frayne, Richard P. Gerraty, Graeme J. Hankey, Suzanne J. Hodgkinson, James T. Hughes, Tim J. Ingall, Peter B. Landau, Richard I. LindleyPaul W. Long, Romesh Markus, Elizabeth M. Mullins, Mark W. Parsons, Michael R.P. Pollack, Stephen J. Read, David M. Rosen, David W. Schultz, David E. Serisier, John D.G. Watson, Catherine E. Storey, Alessandro A. Zagami

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)

Abstract

■ Systematic reviews of randomised trials of tPA in acute ischaemic stroke indicate a clear benefit of treating selected patients within 3 hours of stroke onset. Moreover, a net benefit remained after adjustment for chance baseline imbalances between subgroups in stroke severity within one of these trials (National Institute of Neurological Disorders and Stroke [NINDS]). ■ Rates of favourable outcomes and intracranial haemorrhage comparable with those in randomised trials can be achieved in routine clinical practice; however, translation of net benefit from tPA therapy requires organised and coordinated stroke management across the continuum of care. ■ Prerequisites for well organised and coordinated acute stroke care are: consensus among care providers on the use of tPA; stroke-care teams spanning the gaps between pre-hospital care, emergency departments and stroke units; and collegiate relations and effective communication networks between care providers.

Original languageEnglish
Pages (from-to)634-636
Number of pages3
JournalMedical Journal of Australia
Volume180
Issue number12
DOIs
Publication statusPublished - 21 Jun 2004
Externally publishedYes

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