Research into the efficacy of the stroke drug alteplase has found that its effects continue to last between three and four-and-a-half hours after a stroke, as well as within the usual three-hour treatment window.
A study led by Professor Nils Wahlgren, of Karolinska University Hospital in Sweden, compared stroke patients given alteplase intravenously between three and four-and-a-half hours post-stroke, with those given the drug within three hours.
The findings, published in The Lancet, show that the outcomes relating to incidences of death, brain haemorrhage and patients retaining independence were similar for both groups.
The authors conclude: “Our results show that the rates of symptomatic intracerebral haemorrhage, mortality, and independence at three months follow-up in routine clinical practice are similar between patients for whom treatment was started between three and four-and-a-half hours and for those treated within three hours of ischaemic stroke onset.
“Our findings lend support to those of the meta-analysis suggesting a potentially longer timeframe for intravenous [use of alteplase] of four-and-a-half hours.”
In an accompanying comment, Dr Georgios Tsivgoulis and Dr Andrei Alexandrov of the University of Alabama at Birmingham Hospital in the US said: “Extension of the timeframe of systemic thrombolysis seems to be a safe option for patients with acute stroke.”
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