Evidence map›Paper›PMID 37007347›Full record

ReviewCureus2023

Comparison of Effectiveness and Safety of Low-Dose Versus Standard-Dose Intravenous Recombinant Tissue Plasminogen Activator in Patients With Acute Ischemic Stroke: A Meta-Analysis.

Jithin Karedath, Fnu Avanteeka, Muhammad Nouman Aslam, Ahmad Nadeem, Rao Ahmed Yousaf, Sandesh Shah, Sujith K Palleti, Areeba Khan

Abstract readReview
In one paragraph

Review in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

8 authors.

Jithin KaredathInternal Medicine, King's College Hospital NHS Foundation Trust, London, GBR.
Fnu AvanteekaInternal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK.
Muhammad Nouman AslamMedical College, King Edwards Medical University, Lahore, PAK.
Ahmad NadeemMedicine, Liaquat National Hospital, Karachi, PAK.
Rao Ahmed YousafMedical College, Faisalabad Medical University, Faisalabad, PAK.
Sandesh ShahDepartment of Dermatology, KIST Medical College, Lalitpur, NPL.
Sujith K PalletiNephrology, Edward Hines Jr. Veterans Administration Hospital, Hines, USA.
Areeba KhanCritical Care Medicine, United Medical and Dental College, Karachi, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The aim of the present meta-analysis is to compare the efficacy and safety of low-dose and standard-dose recombinant tissue plasminogen activators (r-tPA) in patients with acute ischemic stroke. The present meta-analysis was conducted according to the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We conducted a systematic search in PubMed, Embase, and the Cochrane Library to identify studies published between January 1, 2010, and January 31, 2023, using the following terms: "stroke," "alteplase," "doses," "efficacy," "tissue plasminogen activator," "r-tPA," and "safety." Primary efficacy outcomes included favorable outcomes (Modified Rankin Scale scores of 0-2), while secondary efficacy outcome was all-cause mortality at 90 days. Safety outcomes included asymptomatic intracerebral hemorrhage (ICH) and symptomatic ICH assessed using the National Institute of Neurological Disorders and Stroke (NINDS) study and the Safe Implementation of Thrombolysis in Stroke-Monitoring (SITS-MOST) study. We also compared parenchymal hematomas as safety outcome between the two groups defined by the authors themselves in their research. A total of 16 studies were included in the present meta-analysis. The meta-analysis did not report any significant difference between low-dose and standard-dose r-tPA in terms of mortality, symptomatic intracranial hemorrhage (SICH), asymptomatic ICH, and parenchymal hematomas. However, the favorable outcome was significantly greater in patients receiving a standard dose of r-tPA.

Indexed as

low dosemeta-analysisrecombinant tissue plasminogen activatorstandard dosestroke

Identifiers

PMID37007347
PMCPMC10062115

What OpenQuestion holds

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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.