Скачать или смотреть (Part 8) - Tissue Plasminogen Activator for Acute Ischemic Stroke

⚡ The cornerstone stroke trial ⚡
The NINDS tPA trial didn’t just prove alteplase worked—it transformed stroke from an untreatable catastrophe into a true emergency.
The Backstory: Before 1995, stroke patients had no proven acute therapy. The bold question: could a clot-buster change outcomes despite hemorrhage risk?
What They Did:
✅ 624 patients with ischemic stroke within 3 hours
✅ Randomized to IV alteplase vs placebo
✅ Outcomes at 90 days (functional independence)
The Results That Mattered:
🏆 Functional independence improved significantly (39% vs 26%, p=0.01)
🏆 Increased early ICH risk, but overall net benefit favored treatment
🏆 Created the framework for “door-to-needle” metrics worldwide
Why This Matters: NINDS established stroke as a true emergency requiring rapid protocols.
Clinical Impact:
• IV tPA ≤3h is standard for eligible ischemic stroke
• Sparked stroke codes, pre-hospital alerts, and fast imaging
The Lesson: Time is brain, and tPA works when given fast.
Do you know your hospital’s current door-to-needle median? 🤔
👆 Follow for stroke-defining trials | Share with your ED/ICU colleagues | Visit NowyouknowNeuro.com for more stroke history
#Neurology #Stroke #NINDS #tPA #DoorToNeedle #EvidenceBasedMedicine

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