schliessen

Filtern

 

Bibliotheken

The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial

Summary Background Thrombolysis is of net benefit in patients with acute ischaemic stroke, who are younger than 80 years of age and are treated within 4·5 h of onset. The third International Stroke Trial (IST-3) sought to determine whether a wider range of patients might benefit up to 6 h from strok... Full description

Journal Title: Lancet 2012, Vol.379 (9834), p.2352-2363
Main Author: Sandercock, Peter
Other Authors: Wardlaw, Joanna M , Lindley, Richard I , Dennis, Martin , Cohen, Geoff , Murray, Gordon , Innes, Karen , Venables, Graham , Czlonkowska, Anna , Kobayashi, Adam , Ricci, Stefano , Murray, Veronica , Berge, Eivind , Slot, Karsten Bruins , Hankey, Graeme J , Correia, Manuel , Peeters, Andre , Matz, Karl , Lyrer, Phillippe , Gubitz, Gord , Phillips, Stephen J , Arauz, Antonio
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Kidlington: Elsevier Ltd
ID: ISSN: 0140-6736
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: cdi_swepub_primary_oai_prod_swepub_kib_ki_se_124769992
title: The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial
format: Article
creator:
  • Sandercock, Peter
  • Wardlaw, Joanna M
  • Lindley, Richard I
  • Dennis, Martin
  • Cohen, Geoff
  • Murray, Gordon
  • Innes, Karen
  • Venables, Graham
  • Czlonkowska, Anna
  • Kobayashi, Adam
  • Ricci, Stefano
  • Murray, Veronica
  • Berge, Eivind
  • Slot, Karsten Bruins
  • Hankey, Graeme J
  • Correia, Manuel
  • Peeters, Andre
  • Matz, Karl
  • Lyrer, Phillippe
  • Gubitz, Gord
  • Phillips, Stephen J
  • Arauz, Antonio
subjects:
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Articles
  • asjc
  • atira
  • Biological and medical sciences
  • Blood pressure
  • Brain
  • Brain Ischemia - drug therapy
  • Care and treatment
  • Clinical Medicine
  • Councils
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Fibrinolytic Agents - administration & dosage
  • Fibrinolytic Agents - adverse effects
  • Fibrinolytic Agents - therapeutic use
  • General aspects
  • Grants
  • Humans
  • Infusions, Intravenous
  • Internal Medicine
  • Ischemia
  • Klinisk medicin
  • Male
  • Medical and Health Sciences
  • Medical research
  • Medical sciences
  • Medicin och hälsovetenskap
  • Medicine(all)
  • Middle Aged
  • Neurologi
  • Neurology
  • Patient outcomes
  • pure
  • Recombinant Proteins - administration & dosage
  • Recombinant Proteins - adverse effects
  • Recombinant Proteins - therapeutic use
  • Secondary Prevention
  • Severity of Illness Index
  • Stroke
  • Stroke - drug therapy
  • Stroke - prevention & control
  • subjectarea
  • Thrombolytic drugs
  • Thrombolytic Therapy - adverse effects
  • Thrombolytic Therapy - methods
  • Tissue Plasminogen Activator - administration & dosage
  • Tissue Plasminogen Activator - adverse effects
  • Tissue Plasminogen Activator - therapeutic use
  • Treatment Outcome
  • Vascular diseases and vascular malformations of the nervous system
  • Venous thrombosis
  • Young Adult
ispartof: Lancet, 2012, Vol.379 (9834), p.2352-2363
description: Summary Background Thrombolysis is of net benefit in patients with acute ischaemic stroke, who are younger than 80 years of age and are treated within 4·5 h of onset. The third International Stroke Trial (IST-3) sought to determine whether a wider range of patients might benefit up to 6 h from stroke onset. Methods In this international, multicentre, randomised, open-treatment trial, patients were allocated to 0·9 mg/kg intravenous recombinant tissue plasminogen activator (rt-PA) or to control. The primary analysis was of the proportion of patients alive and independent, as defined by an Oxford Handicap Score (OHS) of 0–2 at 6 months. The study is registered, ISRCTN25765518. Findings 3035 patients were enrolled by 156 hospitals in 12 countries. All of these patients were included in the analyses (1515 in the rt-PA group vs 1520 in the control group), of whom 1617 (53%) were older than 80 years of age. At 6 months, 554 (37%) patients in the rt-PA group versus 534 (35%) in the control group were alive and independent (OHS 0–2; adjusted odds ratio [OR] 1·13, 95% CI 0·95–1·35, p=0·181; a non-significant absolute increase of 14/1000, 95% CI −20 to 48). An ordinal analysis showed a significant shift in OHS scores; common OR 1·27 (95% CI 1·10–1·47, p=0·001). Fatal or non-fatal symptomatic intracranial haemorrhage within 7 days occurred in 104 (7%) patients in the rt-PA group versus 16 (1%) in the control group (adjusted OR 6·94, 95% CI 4·07–11·8; absolute excess 58/1000, 95% CI 44–72). More deaths occurred within 7 days in the rt-PA group (163 [11%]) than in the control group (107 [7%], adjusted OR 1·60, 95% CI 1·22–2·08, p=0·001; absolute increase 37/1000, 95% CI 17–57), but between 7 days and 6 months there were fewer deaths in the rt-PA group than in the control group, so that by 6 months, similar numbers, in total, had died (408 [27%] in the rt-PA group vs 407 [27%] in the control group). Interpretation For the types of patient recruited in IST-3, despite the early hazards, thrombolysis within 6 h improved functional outcome. Benefit did not seem to be diminished in elderly patients. Funding UK Medical Research Council, Health Foundation UK, Stroke Association UK, Research Council of Norway, Arbetsmarknadens Partners Forsakringsbolag (AFA) Insurances Sweden, Swedish Heart Lung Fund, The Foundation of Marianne and Marcus Wallenberg, Polish Ministry of Science and Education, the Australian Heart Foundation, Australian National Health and Medical Research Counci
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
  • 1474-547X
url: Link


@attributes
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
RANK2.8188255
LOCALfalse
PrimoNMBib
record
control
sourceidgale_swepu
recordidTN_cdi_swepub_primary_oai_prod_swepub_kib_ki_se_124769992
sourceformatXML
sourcesystemPC
galeidA294281469
sourcerecordidA294281469
originalsourceidFETCH-LOGICAL-11025t-7e39fbfd120a7481053f4b8844aaa92717c7ffdf6e4eb33944be83aa787094e53
addsrcrecordideNqNU2uL3DYUNaWl2aT9CS2CUkggk-pl2W4hYUkfWQjthyyhUIqQpasZZT3SVJI37O_sH-r1zGazE7okGNuyfO7RuY_TNN8w-oRRpn54RZmkK9UJ9ZDxR4p2ql-1nzUnTHZy1cruz8-bkxvIveZ-KW8opVLR9svmHudK8IH2J82_5xsgI0TwoRZioiMbk7eFJE9CrNlcQkxzIXWT03ZM01UJhbwNdUMyWNwJ0cRKaihlBrKbTNmGmNYQibE1XJqa8h4dIlFks5AaO1cgodiNgW2wpNScLoA8rCgDcdktx0KOpoYUzfTuf80BP_46e3W-En8_-pEYklFr2oYCjtiEStM04XKP-6r5wpupwNfX7wfN619_OX_-YvXyj9_Onp--XDFGeVtXHYjBj94xTk0ne0Zb4eXY91IaYwbesc523juvQMIoxCDlCL0wpus7OkhoxYNmOBCXt7CbR73LYWvylU4m4Do5fb1_EZZbF9CMy04Nw8Ax9vGdsT-H16c65bWeZy05k22P8KcHOGK34CwszZmOTzz6E8NGr9OlFqJXcli0_n4gSDuIJmQ4inURqi6xeL0TC1HRKHLEclBFB0E5cOV6S8GNsm3piBOIhGcfI8QKCKwU5tCPVHqmpMCi9hTvvnddC9Tb1nuKXC8-gYurTlvgLXOOGWY6N4jBeD4a19PWt4JRoZDqu-tC5fTPDKXqN2nGeZqKxq7zQXUdv4Vamwl0iD5h0SyOk9WnfEC9TKoBUU_-B4WXW2Y3LabB_aOAx7cCxrmECAUfJaw3tazNXMoxvD3AbU6lZPA3aTOqF5frvcv1YmEcHb13uV56-e3tYbiJemdrBHx_DTDFmsmjWWwo73FIJHm7lOGnDwTYUPfWw0TDdCOj3CHj06LvSuLZIRrQopcBsi42QLTgsP-2apfCRxmefsBgpxADJnwBV1De910XrumBZOFgfM_Qiv8AaUSqAg
sourcetypeOpen Access Repository
isCDItrue
recordtypearticle
pqid1022967726
display
typearticle
titleThe benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial
sourceAlma/SFX Local Collection
creatorSandercock, Peter ; Wardlaw, Joanna M ; Lindley, Richard I ; Dennis, Martin ; Cohen, Geoff ; Murray, Gordon ; Innes, Karen ; Venables, Graham ; Czlonkowska, Anna ; Kobayashi, Adam ; Ricci, Stefano ; Murray, Veronica ; Berge, Eivind ; Slot, Karsten Bruins ; Hankey, Graeme J ; Correia, Manuel ; Peeters, Andre ; Matz, Karl ; Lyrer, Phillippe ; Gubitz, Gord ; Phillips, Stephen J ; Arauz, Antonio
creatorcontribSandercock, Peter ; Wardlaw, Joanna M ; Lindley, Richard I ; Dennis, Martin ; Cohen, Geoff ; Murray, Gordon ; Innes, Karen ; Venables, Graham ; Czlonkowska, Anna ; Kobayashi, Adam ; Ricci, Stefano ; Murray, Veronica ; Berge, Eivind ; Slot, Karsten Bruins ; Hankey, Graeme J ; Correia, Manuel ; Peeters, Andre ; Matz, Karl ; Lyrer, Phillippe ; Gubitz, Gord ; Phillips, Stephen J ; Arauz, Antonio ; The IST-3 collaborative group ; IST-3 collaborative group
descriptionSummary Background Thrombolysis is of net benefit in patients with acute ischaemic stroke, who are younger than 80 years of age and are treated within 4·5 h of onset. The third International Stroke Trial (IST-3) sought to determine whether a wider range of patients might benefit up to 6 h from stroke onset. Methods In this international, multicentre, randomised, open-treatment trial, patients were allocated to 0·9 mg/kg intravenous recombinant tissue plasminogen activator (rt-PA) or to control. The primary analysis was of the proportion of patients alive and independent, as defined by an Oxford Handicap Score (OHS) of 0–2 at 6 months. The study is registered, ISRCTN25765518. Findings 3035 patients were enrolled by 156 hospitals in 12 countries. All of these patients were included in the analyses (1515 in the rt-PA group vs 1520 in the control group), of whom 1617 (53%) were older than 80 years of age. At 6 months, 554 (37%) patients in the rt-PA group versus 534 (35%) in the control group were alive and independent (OHS 0–2; adjusted odds ratio [OR] 1·13, 95% CI 0·95–1·35, p=0·181; a non-significant absolute increase of 14/1000, 95% CI −20 to 48). An ordinal analysis showed a significant shift in OHS scores; common OR 1·27 (95% CI 1·10–1·47, p=0·001). Fatal or non-fatal symptomatic intracranial haemorrhage within 7 days occurred in 104 (7%) patients in the rt-PA group versus 16 (1%) in the control group (adjusted OR 6·94, 95% CI 4·07–11·8; absolute excess 58/1000, 95% CI 44–72). More deaths occurred within 7 days in the rt-PA group (163 [11%]) than in the control group (107 [7%], adjusted OR 1·60, 95% CI 1·22–2·08, p=0·001; absolute increase 37/1000, 95% CI 17–57), but between 7 days and 6 months there were fewer deaths in the rt-PA group than in the control group, so that by 6 months, similar numbers, in total, had died (408 [27%] in the rt-PA group vs 407 [27%] in the control group). Interpretation For the types of patient recruited in IST-3, despite the early hazards, thrombolysis within 6 h improved functional outcome. Benefit did not seem to be diminished in elderly patients. Funding UK Medical Research Council, Health Foundation UK, Stroke Association UK, Research Council of Norway, Arbetsmarknadens Partners Forsakringsbolag (AFA) Insurances Sweden, Swedish Heart Lung Fund, The Foundation of Marianne and Marcus Wallenberg, Polish Ministry of Science and Education, the Australian Heart Foundation, Australian National Health and Medical Research Council (NHMRC), Swiss National Research Foundation, Swiss Heart Foundation, Assessorato alla Sanita, Regione dell'Umbria, Italy, and Danube University.
identifier
0ISSN: 0140-6736
1ISSN: 1474-547X
2EISSN: 1474-547X
3DOI: 10.1016/S0140-6736(12)60768-5
4PMID: 22632908
5CODEN: LANCAO
languageeng
publisherKidlington: Elsevier Ltd
subjectAdolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Articles ; asjc ; atira ; Biological and medical sciences ; Blood pressure ; Brain ; Brain Ischemia - drug therapy ; Care and treatment ; Clinical Medicine ; Councils ; Double-Blind Method ; Drug Administration Schedule ; Female ; Fibrinolytic Agents - administration & dosage ; Fibrinolytic Agents - adverse effects ; Fibrinolytic Agents - therapeutic use ; General aspects ; Grants ; Humans ; Infusions, Intravenous ; Internal Medicine ; Ischemia ; Klinisk medicin ; Male ; Medical and Health Sciences ; Medical research ; Medical sciences ; Medicin och hälsovetenskap ; Medicine(all) ; Middle Aged ; Neurologi ; Neurology ; Patient outcomes ; pure ; Recombinant Proteins - administration & dosage ; Recombinant Proteins - adverse effects ; Recombinant Proteins - therapeutic use ; Secondary Prevention ; Severity of Illness Index ; Stroke ; Stroke - drug therapy ; Stroke - prevention & control ; subjectarea ; Thrombolytic drugs ; Thrombolytic Therapy - adverse effects ; Thrombolytic Therapy - methods ; Tissue Plasminogen Activator - administration & dosage ; Tissue Plasminogen Activator - adverse effects ; Tissue Plasminogen Activator - therapeutic use ; Treatment Outcome ; Vascular diseases and vascular malformations of the nervous system ; Venous thrombosis ; Young Adult
ispartofLancet, 2012, Vol.379 (9834), p.2352-2363
rights
0Elsevier Ltd
12012 Elsevier Ltd
22015 INIST-CNRS
3Copyright © 2012 Elsevier Ltd. All rights reserved.
4COPYRIGHT 2012 Elsevier B.V.
5Copyright Elsevier Limited Jun 23-Jun 29, 2012
62012 Elsevier Ltd. All rights reserved. 2012 Elsevier Ltd
lds50peer_reviewed
oafree_for_read
citedbyFETCH-LOGICAL-11025t-7e39fbfd120a7481053f4b8844aaa92717c7ffdf6e4eb33944be83aa787094e53
links
openurl$$Topenurl_article
openurlfulltext$$Topenurlfull_article
thumbnail$$Usyndetics_thumb_exl
backlink
0$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26074256$$DView record in Pascal Francis
1$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22632908$$D View this record in MEDLINE/PubMed
2$$Uhttp://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-421458$$DView record from Swedish Publication Index
3$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:124769992$$DView record from Swedish Publication Index
search
creatorcontrib
0Sandercock, Peter
1Wardlaw, Joanna M
2Lindley, Richard I
3Dennis, Martin
4Cohen, Geoff
5Murray, Gordon
6Innes, Karen
7Venables, Graham
8Czlonkowska, Anna
9Kobayashi, Adam
10Ricci, Stefano
11Murray, Veronica
12Berge, Eivind
13Slot, Karsten Bruins
14Hankey, Graeme J
15Correia, Manuel
16Peeters, Andre
17Matz, Karl
18Lyrer, Phillippe
19Gubitz, Gord
20Phillips, Stephen J
21Arauz, Antonio
22The IST-3 collaborative group
23IST-3 collaborative group
title
0The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial
1Lancet
addtitleLancet
descriptionSummary Background Thrombolysis is of net benefit in patients with acute ischaemic stroke, who are younger than 80 years of age and are treated within 4·5 h of onset. The third International Stroke Trial (IST-3) sought to determine whether a wider range of patients might benefit up to 6 h from stroke onset. Methods In this international, multicentre, randomised, open-treatment trial, patients were allocated to 0·9 mg/kg intravenous recombinant tissue plasminogen activator (rt-PA) or to control. The primary analysis was of the proportion of patients alive and independent, as defined by an Oxford Handicap Score (OHS) of 0–2 at 6 months. The study is registered, ISRCTN25765518. Findings 3035 patients were enrolled by 156 hospitals in 12 countries. All of these patients were included in the analyses (1515 in the rt-PA group vs 1520 in the control group), of whom 1617 (53%) were older than 80 years of age. At 6 months, 554 (37%) patients in the rt-PA group versus 534 (35%) in the control group were alive and independent (OHS 0–2; adjusted odds ratio [OR] 1·13, 95% CI 0·95–1·35, p=0·181; a non-significant absolute increase of 14/1000, 95% CI −20 to 48). An ordinal analysis showed a significant shift in OHS scores; common OR 1·27 (95% CI 1·10–1·47, p=0·001). Fatal or non-fatal symptomatic intracranial haemorrhage within 7 days occurred in 104 (7%) patients in the rt-PA group versus 16 (1%) in the control group (adjusted OR 6·94, 95% CI 4·07–11·8; absolute excess 58/1000, 95% CI 44–72). More deaths occurred within 7 days in the rt-PA group (163 [11%]) than in the control group (107 [7%], adjusted OR 1·60, 95% CI 1·22–2·08, p=0·001; absolute increase 37/1000, 95% CI 17–57), but between 7 days and 6 months there were fewer deaths in the rt-PA group than in the control group, so that by 6 months, similar numbers, in total, had died (408 [27%] in the rt-PA group vs 407 [27%] in the control group). Interpretation For the types of patient recruited in IST-3, despite the early hazards, thrombolysis within 6 h improved functional outcome. Benefit did not seem to be diminished in elderly patients. Funding UK Medical Research Council, Health Foundation UK, Stroke Association UK, Research Council of Norway, Arbetsmarknadens Partners Forsakringsbolag (AFA) Insurances Sweden, Swedish Heart Lung Fund, The Foundation of Marianne and Marcus Wallenberg, Polish Ministry of Science and Education, the Australian Heart Foundation, Australian National Health and Medical Research Council (NHMRC), Swiss National Research Foundation, Swiss Heart Foundation, Assessorato alla Sanita, Regione dell'Umbria, Italy, and Danube University.
subject
0Adolescent
1Adult
2Age Distribution
3Aged
4Aged, 80 and over
5Articles
6asjc
7atira
8Biological and medical sciences
9Blood pressure
10Brain
11Brain Ischemia - drug therapy
12Care and treatment
13Clinical Medicine
14Councils
15Double-Blind Method
16Drug Administration Schedule
17Female
18Fibrinolytic Agents - administration & dosage
19Fibrinolytic Agents - adverse effects
20Fibrinolytic Agents - therapeutic use
21General aspects
22Grants
23Humans
24Infusions, Intravenous
25Internal Medicine
26Ischemia
27Klinisk medicin
28Male
29Medical and Health Sciences
30Medical research
31Medical sciences
32Medicin och hälsovetenskap
33Medicine(all)
34Middle Aged
35Neurologi
36Neurology
37Patient outcomes
38pure
39Recombinant Proteins - administration & dosage
40Recombinant Proteins - adverse effects
41Recombinant Proteins - therapeutic use
42Secondary Prevention
43Severity of Illness Index
44Stroke
45Stroke - drug therapy
46Stroke - prevention & control
47subjectarea
48Thrombolytic drugs
49Thrombolytic Therapy - adverse effects
50Thrombolytic Therapy - methods
51Tissue Plasminogen Activator - administration & dosage
52Tissue Plasminogen Activator - adverse effects
53Tissue Plasminogen Activator - therapeutic use
54Treatment Outcome
55Vascular diseases and vascular malformations of the nervous system
56Venous thrombosis
57Young Adult
issn
00140-6736
11474-547X
21474-547X
fulltexttrue
rsrctypearticle
creationdate2012
recordtypearticle
recordideNqNU2uL3DYUNaWl2aT9CS2CUkggk-pl2W4hYUkfWQjthyyhUIqQpasZZT3SVJI37O_sH-r1zGazE7okGNuyfO7RuY_TNN8w-oRRpn54RZmkK9UJ9ZDxR4p2ql-1nzUnTHZy1cruz8-bkxvIveZ-KW8opVLR9svmHudK8IH2J82_5xsgI0TwoRZioiMbk7eFJE9CrNlcQkxzIXWT03ZM01UJhbwNdUMyWNwJ0cRKaihlBrKbTNmGmNYQibE1XJqa8h4dIlFks5AaO1cgodiNgW2wpNScLoA8rCgDcdktx0KOpoYUzfTuf80BP_46e3W-En8_-pEYklFr2oYCjtiEStM04XKP-6r5wpupwNfX7wfN619_OX_-YvXyj9_Onp--XDFGeVtXHYjBj94xTk0ne0Zb4eXY91IaYwbesc523juvQMIoxCDlCL0wpus7OkhoxYNmOBCXt7CbR73LYWvylU4m4Do5fb1_EZZbF9CMy04Nw8Ax9vGdsT-H16c65bWeZy05k22P8KcHOGK34CwszZmOTzz6E8NGr9OlFqJXcli0_n4gSDuIJmQ4inURqi6xeL0TC1HRKHLEclBFB0E5cOV6S8GNsm3piBOIhGcfI8QKCKwU5tCPVHqmpMCi9hTvvnddC9Tb1nuKXC8-gYurTlvgLXOOGWY6N4jBeD4a19PWt4JRoZDqu-tC5fTPDKXqN2nGeZqKxq7zQXUdv4Vamwl0iD5h0SyOk9WnfEC9TKoBUU_-B4WXW2Y3LabB_aOAx7cCxrmECAUfJaw3tazNXMoxvD3AbU6lZPA3aTOqF5frvcv1YmEcHb13uV56-e3tYbiJemdrBHx_DTDFmsmjWWwo73FIJHm7lOGnDwTYUPfWw0TDdCOj3CHj06LvSuLZIRrQopcBsi42QLTgsP-2apfCRxmefsBgpxADJnwBV1De910XrumBZOFgfM_Qiv8AaUSqAg
startdate2012
enddate2012
creator
0Sandercock, Peter
1Wardlaw, Joanna M
2Lindley, Richard I
3Dennis, Martin
4Cohen, Geoff
5Murray, Gordon
6Innes, Karen
7Venables, Graham
8Czlonkowska, Anna
9Kobayashi, Adam
10Ricci, Stefano
11Murray, Veronica
12Berge, Eivind
13Slot, Karsten Bruins
14Hankey, Graeme J
15Correia, Manuel
16Peeters, Andre
17Matz, Karl
18Lyrer, Phillippe
19Gubitz, Gord
20Phillips, Stephen J
21Arauz, Antonio
general
0Elsevier Ltd
1Elsevier
2Elsevier B.V
3Elsevier Limited
4Lancet Publishing Group
scope
06I.
1AAFTH
2IQODW
3CGR
4CUY
5CVF
6ECM
7EIF
8NPM
9AAYXX
10CITATION
11BSHEE
120TT
130TZ
140U~
153V.
167QL
177QP
187RV
197TK
207U7
217U9
227X7
237XB
2488A
2588C
2688E
2788G
2888I
298AF
308AO
318C1
328C2
338FE
348FH
358FI
368FJ
378FK
388G5
39ABUWG
40AN0
41ASE
42AZQEC
43BBNVY
44BEC
45BENPR
46BHPHI
47C1K
48DWQXO
49FPQ
50FYUFA
51GHDGH
52GNUQQ
53GUQSH
54H94
55HCIFZ
56K6X
57K9-
58K9.
59KB0
60KB~
61LK8
62M0R
63M0S
64M0T
65M1P
66M2M
67M2O
68M2P
69M7N
70M7P
71MBDVC
72NAPCQ
73PQEST
74PQQKQ
75PQUKI
76Q9U
77S0X
78BOBZL
79CLFQK
805PM
81ADTPV
82AOWAS
83D8T
sort
creationdate2012
titleThe benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial
authorSandercock, Peter ; Wardlaw, Joanna M ; Lindley, Richard I ; Dennis, Martin ; Cohen, Geoff ; Murray, Gordon ; Innes, Karen ; Venables, Graham ; Czlonkowska, Anna ; Kobayashi, Adam ; Ricci, Stefano ; Murray, Veronica ; Berge, Eivind ; Slot, Karsten Bruins ; Hankey, Graeme J ; Correia, Manuel ; Peeters, Andre ; Matz, Karl ; Lyrer, Phillippe ; Gubitz, Gord ; Phillips, Stephen J ; Arauz, Antonio
facets
frbrtype5
frbrgroupidcdi_FETCH-LOGICAL-11025t-7e39fbfd120a7481053f4b8844aaa92717c7ffdf6e4eb33944be83aa787094e53
rsrctypearticles
prefilterarticles
languageeng
creationdate2012
topic
0Adolescent
1Adult
2Age Distribution
3Aged
4Aged, 80 and over
5Articles
6asjc
7atira
8Biological and medical sciences
9Blood pressure
10Brain
11Brain Ischemia - drug therapy
12Care and treatment
13Clinical Medicine
14Councils
15Double-Blind Method
16Drug Administration Schedule
17Female
18Fibrinolytic Agents - administration & dosage
19Fibrinolytic Agents - adverse effects
20Fibrinolytic Agents - therapeutic use
21General aspects
22Grants
23Humans
24Infusions, Intravenous
25Internal Medicine
26Ischemia
27Klinisk medicin
28Male
29Medical and Health Sciences
30Medical research
31Medical sciences
32Medicin och hälsovetenskap
33Medicine(all)
34Middle Aged
35Neurologi
36Neurology
37Patient outcomes
38pure
39Recombinant Proteins - administration & dosage
40Recombinant Proteins - adverse effects
41Recombinant Proteins - therapeutic use
42Secondary Prevention
43Severity of Illness Index
44Stroke
45Stroke - drug therapy
46Stroke - prevention & control
47subjectarea
48Thrombolytic drugs
49Thrombolytic Therapy - adverse effects
50Thrombolytic Therapy - methods
51Tissue Plasminogen Activator - administration & dosage
52Tissue Plasminogen Activator - adverse effects
53Tissue Plasminogen Activator - therapeutic use
54Treatment Outcome
55Vascular diseases and vascular malformations of the nervous system
56Venous thrombosis
57Young Adult
toplevel
0peer_reviewed
1online_resources
creatorcontrib
0Sandercock, Peter
1Wardlaw, Joanna M
2Lindley, Richard I
3Dennis, Martin
4Cohen, Geoff
5Murray, Gordon
6Innes, Karen
7Venables, Graham
8Czlonkowska, Anna
9Kobayashi, Adam
10Ricci, Stefano
11Murray, Veronica
12Berge, Eivind
13Slot, Karsten Bruins
14Hankey, Graeme J
15Correia, Manuel
16Peeters, Andre
17Matz, Karl
18Lyrer, Phillippe
19Gubitz, Gord
20Phillips, Stephen J
21Arauz, Antonio
22The IST-3 collaborative group
23IST-3 collaborative group
collection
0ScienceDirect Open Access Titles
1Elsevier:ScienceDirect:Open Access
2Pascal-Francis
3Medline
4MEDLINE
5MEDLINE (Ovid)
6MEDLINE
7MEDLINE
8PubMed
9CrossRef
10Academic OneFile (A&I only)
11News PRO
12Pharma and Biotech Premium PRO
13Global News & ABI/Inform Professional
14ProQuest Central (Corporate)
15Bacteriology Abstracts (Microbiology B)
16Calcium & Calcified Tissue Abstracts
17Nursing & Allied Health Database
18Neurosciences Abstracts
19Toxicology Abstracts
20Virology and AIDS Abstracts
21Health & Medical Collection
22ProQuest Central (purchase pre-March 2016)
23Biology Database (Alumni Edition)
24Healthcare Administration Database (Alumni)
25Medical Database (Alumni Edition)
26Psychology Database (Alumni)
27Science Database (Alumni Edition)
28STEM Database
29ProQuest Pharma Collection
30Public Health Database
31Lancet Titles
32ProQuest SciTech Collection
33ProQuest Natural Science Collection
34Hospital Premium Collection
35Hospital Premium Collection (Alumni Edition)
36ProQuest Central (Alumni) (purchase pre-March 2016)
37Research Library (Alumni Edition)
38ProQuest Central (Alumni Edition)
39British Nursing Database
40British Nursing Index
41ProQuest Central Essentials
42Biological Science Collection
43eLibrary
44ProQuest Central
45Natural Science Collection
46Environmental Sciences and Pollution Management
47ProQuest Central Korea
48British Nursing Index (BNI) (1985 to Present)
49Health Research Premium Collection
50Health Research Premium Collection (Alumni)
51ProQuest Central Student
52Research Library Prep
53AIDS and Cancer Research Abstracts
54SciTech Premium Collection
55British Nursing Index
56Consumer Health Database (Alumni Edition)
57ProQuest Health & Medical Complete (Alumni)
58Nursing & Allied Health Database (Alumni Edition)
59ProQuest Newsstand Professional
60ProQuest Biological Science Collection
61Consumer Health Database
62Health & Medical Collection (Alumni Edition)
63Healthcare Administration Database
64Medical Database
65Psychology Database
66Research Library
67Science Database
68Algology Mycology and Protozoology Abstracts (Microbiology C)
69Biological Science Database
70Research Library (Corporate)
71Nursing & Allied Health Premium
72ProQuest One Academic Eastern Edition
73ProQuest One Academic
74ProQuest One Academic UKI Edition
75ProQuest Central Basic
76SIRS Editorial
77OpenAIRE (Open Access)
78OpenAIRE
79PubMed Central (Full Participant titles)
80SwePub
81SwePub Articles
82SWEPUB Freely available online
jtitleLancet
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Sandercock, Peter
1Wardlaw, Joanna M
2Lindley, Richard I
3Dennis, Martin
4Cohen, Geoff
5Murray, Gordon
6Innes, Karen
7Venables, Graham
8Czlonkowska, Anna
9Kobayashi, Adam
10Ricci, Stefano
11Murray, Veronica
12Berge, Eivind
13Slot, Karsten Bruins
14Hankey, Graeme J
15Correia, Manuel
16Peeters, Andre
17Matz, Karl
18Lyrer, Phillippe
19Gubitz, Gord
20Phillips, Stephen J
21Arauz, Antonio
aucorp
0The IST-3 collaborative group
1IST-3 collaborative group
formatjournal
genrearticle
ristypeJOUR
atitleThe benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial
jtitleLancet
addtitleLancet
date2012
risdate2012
volume379
issue9834
spage2352
epage2363
pages2352-2363
issn
00140-6736
11474-547X
eissn1474-547X
codenLANCAO
notesMembers listed in the appendix
abstractSummary Background Thrombolysis is of net benefit in patients with acute ischaemic stroke, who are younger than 80 years of age and are treated within 4·5 h of onset. The third International Stroke Trial (IST-3) sought to determine whether a wider range of patients might benefit up to 6 h from stroke onset. Methods In this international, multicentre, randomised, open-treatment trial, patients were allocated to 0·9 mg/kg intravenous recombinant tissue plasminogen activator (rt-PA) or to control. The primary analysis was of the proportion of patients alive and independent, as defined by an Oxford Handicap Score (OHS) of 0–2 at 6 months. The study is registered, ISRCTN25765518. Findings 3035 patients were enrolled by 156 hospitals in 12 countries. All of these patients were included in the analyses (1515 in the rt-PA group vs 1520 in the control group), of whom 1617 (53%) were older than 80 years of age. At 6 months, 554 (37%) patients in the rt-PA group versus 534 (35%) in the control group were alive and independent (OHS 0–2; adjusted odds ratio [OR] 1·13, 95% CI 0·95–1·35, p=0·181; a non-significant absolute increase of 14/1000, 95% CI −20 to 48). An ordinal analysis showed a significant shift in OHS scores; common OR 1·27 (95% CI 1·10–1·47, p=0·001). Fatal or non-fatal symptomatic intracranial haemorrhage within 7 days occurred in 104 (7%) patients in the rt-PA group versus 16 (1%) in the control group (adjusted OR 6·94, 95% CI 4·07–11·8; absolute excess 58/1000, 95% CI 44–72). More deaths occurred within 7 days in the rt-PA group (163 [11%]) than in the control group (107 [7%], adjusted OR 1·60, 95% CI 1·22–2·08, p=0·001; absolute increase 37/1000, 95% CI 17–57), but between 7 days and 6 months there were fewer deaths in the rt-PA group than in the control group, so that by 6 months, similar numbers, in total, had died (408 [27%] in the rt-PA group vs 407 [27%] in the control group). Interpretation For the types of patient recruited in IST-3, despite the early hazards, thrombolysis within 6 h improved functional outcome. Benefit did not seem to be diminished in elderly patients. Funding UK Medical Research Council, Health Foundation UK, Stroke Association UK, Research Council of Norway, Arbetsmarknadens Partners Forsakringsbolag (AFA) Insurances Sweden, Swedish Heart Lung Fund, The Foundation of Marianne and Marcus Wallenberg, Polish Ministry of Science and Education, the Australian Heart Foundation, Australian National Health and Medical Research Council (NHMRC), Swiss National Research Foundation, Swiss Heart Foundation, Assessorato alla Sanita, Regione dell'Umbria, Italy, and Danube University.
copKidlington
pubElsevier Ltd
pmid22632908
doi10.1016/S0140-6736(12)60768-5
oafree_for_read