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Efficacy and safety of intravenous recombinant tissue plasminogen activator in mild ischaemic stroke: a meta-analysis

Shoujiang You, Anubhav Saxena, Xia Wang, WeeYong Tan, Qiao Han, Yongjun Cao, Chun-Feng Liu
DOI: 10.1136/svn-2017-000106 Published 22 March 2018
Shoujiang You
1 Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Anubhav Saxena
2 The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
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Xia Wang
2 The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
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WeeYong Tan
3 Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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Qiao Han
4 Department of Neurology, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, China
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Yongjun Cao
1 Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
5 Institutes of Neuroscience, Soochow University, Suzhou, China
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Chun-Feng Liu
1 Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
5 Institutes of Neuroscience, Soochow University, Suzhou, China
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  • Figure 1
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    Figure 1

    Flow chart of literature screening and selection process. tPA, tissue plasminogen activator.

  • Figure 2
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    Figure 2

    Forest plot for excellent outcome of IV-tPA-treated MIS compared with those without IV-tPA treatment. IV-tPA, intravenous recombinant tissue plasminogen activator; M-H, Mantel-Haenszel; MIS, mild ischaemic stroke.

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    Figure 3

    Funnel plot for publication bias for excellent outcome of intravenous recombinant tissue plasminogen activator-treated mild ischaemic stroke.

  • Figure 4
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    Figure 4

    Forest plot for symptomatic intracranial haemorrhage of IV-tPA-treated mild ischaemic stroke compared with those without IV-tPA treatment. IV-tPA, intravenous recombinant tissue plasminogen activator; M-H, Mantel-Haenszel.

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    Figure 5

    Forest plot for mortality of IV-tPA-treated mild ischaemic stroke compared with those without IV-tPA treatment. IV-tPA, intravenous recombinant tissue plasminogen activator; M-H, Mantel-Haenszel .

Tables

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  • Table 1

    Characteristics of studies included in the review

    PublicationOriginCasesDefinitionTime to needle
    (hours)
    AgeMenDefinition of sICHBaseline
    NIHSS score
    mRS 0–1 at 3 months or OHS 0–1 at
    6 months
    sICHMortality at 3 months
    Khatri et al 21 USA58≤5<366.2 (12.0)42 (72.4)ICH with NIHSS ≥14 (4)46 (79.3)1 (1.7)1 (1.7)
    Huisa et al 18 USA133≤5<368.5 (15.4)79 (59.4)ICH with NIHSS ≥12.6 (1.5)85 (63.9)3 (2.3)6 (4.5)
    Urra et al 12 Spain203≤5<4.568.9 (13.5)134 (66.0)ICH with NIHSS ≥43 (2–4)
    2 (1–3.8)
    167 (82.3)05 (2.5)
    Greisenegger et al 11 Austria890≤5<370 (61–78)
    70 (62–78)
    518 (58.2)ICH with NIHSS ≥14 (3–5)609 (68.4)11 (1.2)27 (3.0)
    Nesi et al 13 Italy128≤6<365.6 (11.6)92 (71.9)ICH with NIHSS ≥1NA108 (84.4)00
    Khatri et al 14 USA106≤5<382
    81
    63 (59.4)ICH with significant neurological deterioration459 (55.7)03 (2.8)
    Ng et al 16 Australia73≤3<4.573.2 (67.3–82.8)45 (61.6)ICH with NIHSS ≥42 (1–3)59 (80.8)00

Supplementary Materials

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    [SP1.pdf]

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Stroke and Vascular Neurology: 3 (1)
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Efficacy and safety of intravenous recombinant tissue plasminogen activator in mild ischaemic stroke: a meta-analysis
Shoujiang You, Anubhav Saxena, Xia Wang, WeeYong Tan, Qiao Han, Yongjun Cao, Chun-Feng Liu
Stroke and Vascular Neurology Mar 2018, 3 (1) 22-27; DOI: 10.1136/svn-2017-000106

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Efficacy and safety of intravenous recombinant tissue plasminogen activator in mild ischaemic stroke: a meta-analysis
Shoujiang You, Anubhav Saxena, Xia Wang, WeeYong Tan, Qiao Han, Yongjun Cao, Chun-Feng Liu
Stroke and Vascular Neurology Mar 2018, 3 (1) 22-27; DOI: 10.1136/svn-2017-000106
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Efficacy and safety of intravenous recombinant tissue plasminogen activator in mild ischaemic stroke: a meta-analysis
Shoujiang You, Anubhav Saxena, Xia Wang, WeeYong Tan, Qiao Han, Yongjun Cao, Chun-Feng Liu
Stroke and Vascular Neurology Mar 2018, 3 (1) 22-27; DOI: 10.1136/svn-2017-000106
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