It’s medical news nonsense time again – this time featuring our old favorite, tPA for stroke.
“Tissue Plasminogen Activators Safe for Patients Who Wake Up with Stroke Symptoms” reports HCP Live, and featured in the ACEP daily e-mail newsletter. Oddly enough, this article was actually initially published back in July before being picked up by the health news blog world here in December.
As the headline suggests, this is an article regarding “wake-up” strokes, those with an unknown time of onset because the patient was last seen normal prior to sleep. The authors hypothesize this might represent an otherwise missed, but eligible, population if their stroke onset was close to waking.
But, in this open-label study spanning 3 years of enrollment, there is absolutely nothing conclusive to be said. During this period, across five centers, these authors managed to enroll only 40 patients – the vast majority of whom had NIHSS less than 10, and four of whom were mimics. Following treatment, six suffered intracerebral hemorrhage, two developed angioedema, and one suffered systemic hemorrhage – and thus, the apparent conclusion, that tPA is “safe” in this population.
In reality, this hardly tells us anything of the sort – generalizing results from this cohort of mostly small strokes to a larger treatment population is obviously inappropriate. But, the authors state it forms the foundation of future trials – and, no doubt, they are underway already.
“Prospective, Open-Label Safety Study of Intravenous Recombinant Tissue Plasminogen Activator in Wake-Up Stroke”
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