The third international stroke trial (IST-3) of thrombolysis for acute ischaemic stroke
2008

IST-3 Study on Thrombolysis for Stroke

Sample size: 6000 publication Evidence: moderate

Author Information

Author(s): Peter Sandercock, Richard Lindley, Joanna Wardlaw, Martin Dennis, Steff Lewis, Graham Venables, Adam Kobayashi, Anna Czlonkowska, Eivind Berge, Karsten Bruins Slot, Veronica Murray, Andre Peeters, Graeme Hankey, Karl Matz, Michael Brainin, Stefano Ricci, Maria Grazia Celani, Enrico Righetti, Teresa Cantisani, Gord Gubitz, Steve Phillips, Antonio Arauz, Kameshwar Prasad, Manuel Correia, Phillippe Lyrer

Primary Institution: The IST-3 Co-ordinating Centre, Neurosciences Trials Unit, University of Edinburgh

Hypothesis

That intravenous recombinant tissue plasminogen activator (rt-PA) in a dose of 0.9 mg/kg (maximum 90 mg) administered to patients with acute ischaemic stroke, within six hours of symptom onset, increases the proportion of people alive and independent at six months.

Conclusion

The study aims to determine if a wider range of patients can benefit from thrombolysis treatment for acute ischaemic stroke.

Supporting Evidence

  • Thrombolysis has been a standard treatment for acute myocardial infarction since the late 1980s.
  • The NINDS rt-PA Stroke Study group was the first trial to show evidence of benefit for thrombolysis in stroke patients.
  • The Cochrane review included data from 8 randomised trials including 2955 patients.

Takeaway

This study is trying to find out if a medicine can help more people recover from a type of stroke if given quickly.

Methodology

International, multi-centre, prospective, randomized, open, blinded endpoint (PROBE) trial of intravenous rt-PA in acute ischaemic stroke.

Potential Biases

There may be biases in treatment allocation and patient selection due to varying clinical practices.

Limitations

The study may not include enough older patients and has uncertainties about the effects of treatment in some patient categories.

Participant Demographics

Patients with mild, moderate, or severe strokes, with no upper age limit.

Statistical Information

Confidence Interval

95% CI 0.69 to 0.93

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1745-6215-9-37

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