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Comment & Response
August 11, 2015

Intervention for Acute Stroke—Reply

Author Affiliations
  • 1Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA. 2015;314(6):626-627. doi:10.1001/jama.2015.7851

In Reply In our recent article, we reviewed major thrombolytic stroke trials and a pooled meta-analysis that confirmed favorable clinical outcome at 3 months if intravenous recombinant tissue plasminogen activator (rtPA) was provided between 3 and 4.5 hours of symptom onset. However, because the majority of patients were contributed by a single European trial, the European Cooperative Acute Stroke Study1 (ECASS-3), we were careful to state that “… in the 3- to 4.5-hour window, rtPA is recommended for patients with moderately severe symptoms younger than 80 years and without contraindications in some guidelines for stroke management.”

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