Evidence map›Paper›PMID 25938622›Full record

ArticleExpert review of neurotherapeutics2015

Why don't more patients receive intravenous rt-PA for acute stroke?

Patrick Lyden

Open access · bronzeAbstract readEditorial
In one paragraph

Article in Expert review of neurotherapeutics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

Patrick LydenDepartment of Neurology, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., AHSP A6417, Los Angeles, CA 90036, USA.
Cedars-Sinai Medical Center · US

Funding

ZZ-3K3A-201: Safety evaluation of 3K3A-APC in ischemic strokeU01NS088312 · NINDS · CEDARS-SINAI MEDICAL CENTER · PI LYDEN, PATRICK D · 2014 to 2017
$7.4M
Thrombin Mediated Cytotoxicity during Cerebral IschemiaR01NS075930 · NINDS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI LYDEN, PATRICK D · 2011 to 2020
$3.6M
NINDS NIH HHS NS075930NINDS NIH HHS R01 NS075930NINDS NIH HHS U01 NS088312
6 · The paper itself

Abstract

Intravenous rt-PA was proven safe and effective for acute ischemic stroke in 1995, approved by US FDA in 1996, and endorsed by the American Heart Association, American Academy of Neurology, and National Stroke Association in 1997. The treatment is remarkably cost-effective, despite the high cost of the drug itself and the stroke teams to give it. Community-based practicing neurologists can use t-PA for acute stroke without the need for specialized expertise. The benefit is durable over long-term follow-up and no particular subgroups, such as the elderly or those with very large strokes, should be excluded from treatment. Several additional studies have now confirmed the beneficial effects of thrombolytic therapy for stroke in de novo samples. So why isn't the drug used more? Some troubling mis-understandings in the literature seem persistent and influential among clinicians. Considerable data supports the use of rt-PA for acute ischemic stroke, which should remove remaining doubts.

Indexed as

Administration, IntravenousFibrinolytic AgentsHumansStrokeTissue Plasminogen ActivatorFibrinolytic AgentsTissue Plasminogen Activatorcost-effectivenesshemorrhagestroketherapythrombolysis

Identifiers

PMID25938622
PMCPMC4830472
OpenAlexW1729063037

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.