Intravenous thrombolysis for acute ischemic stroke in Asia. (February 2012)

• Record Type: Journal Article
• Authors: Sharma, Vijay K; Ng, Kay WP; Venketasubramanian, Narayanaswamy; Teoh, Hock L; Chan, Bernard PL
• Is Part Of: Expert review of neurotherapeutics. Volume 12:Number 2(2012)
• Page Start: 209
• Page End: 217
• Publication Date: 2012-02
• Subjects: acute ischemic stroke -- Asian -- developing countries -- thrombolysis -- tissue plasminogen activator; Neuropharmacology -- Periodicals; 615.7805
• DOI: 10.1586/ern.11.148
• Languages: English
• ISSNs: 1473-7175

Abstract

Data regarding thrombolysis for acute ischemic stroke in Asia are scarce and only a small percentage of patients are thrombolysed. Clinical trials that led to the recommended dose of intravenously administered tissue plasminogen activator (IV-tPA) included predominantly Caucasian patients. However, the single-arm case-controlled observational studies in Japanese patients suggested the clinical efficacy and safety of low-dose IV-tPA (0.6 mg/kg bodyweight; maximum 60 mg) comparable with standard dose (0.9 mg/kg bodyweight; maximum 90 mg). There has been no randomized clinical trial for determining the dose, efficacy or safety of IV-tPA in Asia. Accordingly, the dose of IV-tPA in Asia remains controversial. Reduced treatment cost, lower symptomatic intracerebral hemorrhage risk and comparable efficacy encouraged many Asian centers to adopt low-dose or even variable-dose IV-tPA regimens. We present the current status of thrombolysis for acute ischemic stroke in Asia.