EBQ:IST-3
PubMed Full text
Clinical Question
Can use of fibrinolytics for acute ischemic stroke be extended to a wider range of patients up to 6 hours?
Conclusion
Thrombolysis within 6 hours improved functional outcome even though there were early hazards. This applies to the population of patients recruited for IST-3, benefits appear to be seen in the elderly as well.
Major Points
Study Design
- International, randomized controlled trial
- open treatment
Inclusion Criteria
- Signs and symptoms of acute stroke
- Known time of stroke onset
- Treatment could be started within 6 hours of onset
- CT or MRI excluded ICH and brain lesion
- Patient and clinician felt the treatment was "promising but unproven"
- If patient had indication for IV thrombolysis- treated with local guidelines
Exclusion Criteria
Interventions
Outcome
Primary Outcomes
Secondary Outcomes
Subgroup analysis
Criticisms
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.