Randomised controlled trials and meta-analysis of thrombolysis in acute stroke showing rates of early death up to 30 days, dependency (usually defined as a Rankin score greater than 2 (inclusive) or death at up to 6 months and rates of symptomatic intracranial haemorrhage)
Trial | No | Drug/time | Thrombolytic (%) | Control (%) |
ASK13 | 340 | SK | ||
Early death (7 days)* | <4 hours | 17.8 | 10.9 | |
Death/dependency (3 months) | 42.3 | 44.6 | ||
Haemorrhage* | 12.6 | 2.4 | ||
MAST-E15 | 310 | SK | ||
Early death (10 days)* | <6 hours | 34.0 | 18.2 | |
Death/dependency (6 months) | 79.5 | 81.8 | ||
Haemorrhage* | 21.2 | 2.6 | ||
MAST-I14 | 622 | SK | ||
Early death (10 days)* | <6 hours | 26.5 | 11.7 | |
Death/dependency (6 months) | 62.6 | 64.7 | ||
Haemorrhage* | 8.0 | 1.3 | ||
ECASS 116 | 620 | rtPA | ||
Early death (30 days)* | <6 hours | 17.9 | 12.7 | |
Death/dependency (3 months) | 63.3 | 71.7 | ||
Haemorrhage* | 19.8 | 6.5 | ||
NINDS12 | 624 | rtPA | ||
Early death (30 days) | <3 hours | 12.8 | 15.7 | |
Death/dependency (3 months)* | 57.4 | 73.4 | ||
Haemorrhage* | 6.4 | 0.6 | ||
Meta-analysis22 | ||||
Early death* | 3435 | SK/rtPA | 20.9 | 11.8 |
Death/dependency* | 61.5 | 68 | ||
Haemorrhage* | 9.6 | 2.6 | ||
ECASS 217 | 800 | rtPA | ||
Early death (7 days) | <6 hours | 6.1 | 4.9 | |
Death/dependency (3 months) | 59.7 | 63.4 | ||
Haemorrhage* | 8.8 | 3.4 | ||
ATLANTIS18 | 613 | rtPA | ||
Early death (30 days) | 3–5 hours | 7.6 | 4.2 | |
Death/dependency (3 months) | 58.3 | 59.5 | ||
Haemorrhage* | 6.7 | 1.3 |
The asterisks (*) signify that the difference between the two groups reached statistical significance. No is the number of subjects in each study; SK is streptokinase and rtPA is recombinant tissue plasminogen activator.