Thrombolysis Benefit for Mild Stroke Remains Unclear

A randomized trial that was stopped early showed no benefit.

Tissue plasminogen activator (TPA) is the only FDA-approved pharmacologic treatment for acute ischemic stroke. Whether TPA benefits patients with initial presentation of a mild stroke remains controversial. Some studies suggest that most patients do well with conservative treatment (Stroke 2007; 38:2531), whereas other analyses have found that patients with mild stroke can worsen, and up to 30% may have later disability (Stroke 2012; 43:560).

To examine this issue, researchers aimed to recruit 948 patients in a randomized trial of TPA versus aspirin for patients with a mild, nondisabling stroke treatable within 3 hours. The description “mild, nondisabling” was operationally defined as an NIH stroke scale score of 0 to 5, whereas a clearly di…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Thrombolysis Benefit for Mild Stroke Remains Unclear

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Reviewing Author