Feasibility and outcomes of intravenous thrombolysis 3-4.5 hours after stroke in Chinese patients

J Clin Neurosci. 2014 May;21(5):822-6. doi: 10.1016/j.jocn.2013.08.014. Epub 2013 Oct 19.


The time window for intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment in acute ischemic stroke (AIS) patients has been extended to 4.5 hours. But little is known about the safety and efficacy of IV rt-PA treatment in the 3-4.5 hour time window in Chinese patients with AIS. A total of 119 patients who were treated with standard IV rt-PA therapy within 4.5 hours after symptom onset were included in this study: 85 were treated within 0-3 hours and 34 were treated within 3-4.5 hours. Favorable outcome was defined as a modified Rankin scale (mRS) score of 0-1 at 6 months. The safety of IV rt-PA treatment was assessed by the rate of mortality, symptomatic intracerebral hemorrhage (SICH) and other common complications. There were no significant differences in SICH rates (2.94% versus 2.35%; p=0.85) at 24-36 hours, mortality (5.88% versus 3.53%; p=0.56), other complications (14.71% versus 11.76%; p=0.66), National Institutes of Health Stroke Scale (NIHSS) score improvement at 24 hours (41.18% versus 45.88%; p=0.64) and favorable mRS at 6 months (52.94% versus 54.12%; p=0.91) between the two time window groups. Multivariate analysis showed that advanced age, lower admission NIHSS score and shorter time from symptom onset to treatment were associated with a favorable clinical outcome. This finding showed an additional 29% of patients received IV rt-PA because of the treatment window expansion to 4.5 hours. IV rt-PA was feasible and safe for treating AIS patients in the 3-4.5 hour time window in our Chinese population.

Keywords: Acute stroke; China; Thrombolysis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asian People / ethnology*
  • Feasibility Studies
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Prospective Studies
  • Stroke / diagnosis
  • Stroke / drug therapy*
  • Stroke / ethnology*
  • Thrombolytic Therapy / methods*
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage*
  • Treatment Outcome


  • Tissue Plasminogen Activator