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IV alteplase (recombinant t-PA), given for thrombolysis in acute ischemic stroke, is widely recommended as the standard of care, based on reduced morbidity in multiple randomized controlled trials. But is this therapy, with its risk for intracerebral hemorrhage, safe in daily clinical practice?
In a European Union–mandated, manufacturer-supported observational safety study, researchers followed 6483 patients with acute ischemic stroke (median age, 68) who received alteplase within 3 hours of symptom onset. Of the 285 centers participating in the 40-month study, about half had previously treated fewer than five stroke patients with alteplase. Outcomes in the observational cohort were compared with those in patients treated with alteplase in f…