Impact of computed tomography perfusion imaging on the response to tenecteplase in ischemic stroke: analysis of two randomized controlled trials

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Bivard, Andrew; Huang, Xuya; McElduff, Patrick; Levi, Christopher R.; Campbell, Bruce C.V.; Cheripelli, Bharath Kumar; Kalladka, Dheeraj; Moreton, Fiona Catherine; Ford, Ian; Bladin, Christopher F.; Davis, Stephen M.; Donnan, Geoffrey A.; Muir, Keith W.; Parsons, Mark W.;
  • Publisher: American Heart Association

Background: We pooled 2 clinical trials of tenecteplase compared with alteplase for the treatment of acute ischemic stroke, 1 that demonstrated superiority of tenecteplase and the other that showed no difference between the treatments in patient clinical outcomes. We te... View more
  • References (4)

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    3 Davis SM, Donnan GA, Parsons MW, Levi C, Butcher KS, Peeters A, Barber PA, Bladin C, De Silva DA, Byrnes G, Chalk JB, Fink JN, Kimber TE, Schultz D, Hand PJ, Frayne J, Hankey G, Muir K, Gerraty R, Tress BM, Desmond PM; EPITHET investigators. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial. Lancet Neurol. 2008;7:299-309.

    4 Lansberg MG, Straka M, Kemp S, Mlynash M, Wechsler LR, Jovin TG, Wilder MJ, Lutsep HL, Czartoski TJ, Bernstein RA, Chang CW, Warach S, Fazekas F, Inoue M, Tipirneni A, Hamilton SA, Zaharchuk G, Marks MP, Bammer R, Albers GW; DEFUSE 2 study investigators. MRI profile and response to endovascular reperfusion after stroke (DEFUSE 2): a prospective cohort study. Lancet Neurol. 2012;11:860-7. Figure 1. Comparison patient outcomes between tenecteplase and alteplase patients in all patients from ATTEST and Australian-TNK studies. In a pooled analysis, patients did not have better 3 month outcomes on dichotomous outcome measures (mRS 0-1 1.75 CI, 0.89, 3.75 p=0.11) or ordinal analysis (OR 0.56 CI, 0.31-1.01, p=0.055)

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