In Reply: Dr Pastewski and colleagues would
like more information on patients treated with alteplase after 3 hours. In
our study, no patient received alteplase less than 60 minutes before or 270
minutes after onset of symptoms. Of the 40 patients (18%) who received alteplase
after 3 hours, 20 (50%) had a poor outcome (modified Rankin scale ≥3) at
90 days. The study was not powered to demonstrate a statistically significant
difference in outcome at 90 days between patients that received alteplase
within or outside the 3-hour window.
Saposnik G, Young B, Hachinski V. Predictors of Lack of Improvement After Thrombolytic Stroke Therapy—Reply. JAMA. 2005;293(4):421. doi:10.1001/jama.293.4.421-b
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