Evidence map›Paper›PMID 37587045›Full record

ArticleJournal of atherosclerosis and thrombosis2024

Improvement of Functional Outcomes in Patients with Stroke who Received Alteplase for Over 15 Years: Japan Stroke Data Bank.

Akiko Ishigami, Kazunori Toyoda, Michikazu Nakai, Sohei Yoshimura, Shinichi Wada, Yusuke Sasahara, Kazutaka Sonoda, Kaori Miwa, Junpei Koge, Masayuki Shiozawa and 7 more

Open access · diamondAbstract read
In one paragraph

Article in Journal of atherosclerosis and thrombosis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 42% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Development of tenecteplase for stroke thrombolysis: Japan's endeavor.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Review
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

17 authors at 6 institutions in 2 countries.

Akiko IshigamiDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Kazunori ToyodaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Michikazu NakaiDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Sohei YoshimuraDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Shinichi WadaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Yusuke SasaharaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Kazutaka SonodaDepartment of Neurology, Saiseikai Fukuoka General Hospital.
Kaori MiwaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Junpei KogeDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Masayuki ShiozawaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Yoshitaka IwanagaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Yoshihiro MiyamotoDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Jin NakaharaDepartment of Neurology, Keio University School of Medicine.
Norihiro SuzukiDepartment of Neurology, Keio University School of Medicine.
Shotai KobayashiShimane University School of Medicine.
Kazuo MinematsuMedical Corporation ISEIKAI.
Masatoshi KogaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
National Cerebral and Cardiovascular Center · JPHealth Information Management · BEKeio University · JPKishokai Medical Corporation · JPSaiseikai Fukuoka General Hospital · JPShimane University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe nationwide verification of intravenous thrombolysis (IVT) was rarely performed after the extension of the therapeutic time window of alteplase or after the expansion of mechanical thrombectomy (MT). We aimed to examine the long-term change in accurate real-world outcomes of IVT in patients with acute ischemic stroke (AIS) using the Japan Stroke Databank, a representative Japan-wide stroke database.

methodsWe extracted all patients with AIS who received IVT with alteplase between October 11, 2005, the approval date for alteplase use for AIS in Japan, and December 31, 2020. Patients were categorized into three groups using two critical dates in Japan as cutoffs: the official extension date of the therapeutic time window for IVT to within 4.5 h of symptom onset and the publication date of the revised guideline, where the evidence level of MT was heightened. We assessed the yearly trend of IVT implementation rates and the secular changes and three-group changes in clinical outcomes at discharge.

resultsOf 124,382 patients with AIS, 9,569 (7.7%) received IVT (females, 41%; median age, 75 years). The IVT implementation rate has generally increased over time and plateaued in recent years. The proportion of favorable outcomes (modified Rankin Scale score of 0-2) increased yearly over 15 years. The results of the changes in the outcomes of the three groups were similar to those of the annual changes.

conclusionsWe revealed that IVT implementation rates in patients with AIS increased, and the functional outcome in these patients improved over 15 years. Therefore, the Japanese IVT dissemination strategy is considered appropriate and effective.

Indexed as

Brain IschemiaIschemic StrokeStrokeAgedFemaleFibrinolytic AgentsHumansJapanThrombectomyThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTissue Plasminogen ActivatorAcute ischemic strokeEndovascular therapyIntravenous thrombolysisSecular changeTherapeutic time window

Identifiers

PMID37587045
PMCPMC10776302
OpenAlexW4385859942

What OpenQuestion holds

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Registered trials

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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.