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NINDS rt-PA Stroke Study

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study.

624 patients with iscahemic stroke were treated with 0.9 mg/kg (max 90 mg) rt-PA within 3 hours after the onset of symptoms. Half of the patients received treatment within 90 minutes.

Of the rt-PA treated patients 31-50% had complete or near-complete recovery at 3 months compared with 20-38% given placebo. This benefit was similar at 1 year.

The main hazard was of symptomatic cerebral haemorrhage in 6.4% of the treatment group compared with 0.6% in the placebo group. Indiviuduals with a more severe intial neurological defect or mass effect on the baseline CT scan were at greater risk of this complication.

Mortality was similar in both groups rt-PA vs placebo, at 3 months 17% vs 20%, at 1 year 24% vs 28%.

Reference:

  • (1) Brott, Bogousslavsky (2000). Treatment of acute ischaemic stroke. NEJM, 343, 710-722

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