PT  - JOURNAL ARTICLE
AU  - Salem, Gelan M.
AU  - El-Sheik, Wafik M.
AU  - El-shanawany, Basma G.
AU  - Afifi, Khaled H.
TI  - Low versus standard dose intravenous alteplase in the treatment of acute ischemic stroke in Egyptian patients
AID  - 10.17712/nsj.2021.2.20200148
DP  - 2021 Apr 01
TA  - Neurosciences Journal
PG  - 179--185
VI  - 26
IP  - 2
4099  - http://nsj.org.sa/content/26/2/179.short
4100  - http://nsj.org.sa/content/26/2/179.full
SO  - Neurosciences (Riyadh)2021 Apr 01; 26
AB  - Objectives: To assess low dose altepase outcome and safety in comparison with a standard-dose regimen for acute ischemic stroke treatment in Egyptian patients.Materials: An observational prospective cohort non-randomized single blinded study was carried out during the period from November 2017 to December 2018. Eighty Egyptian acute ischemic stroke patients, all eligible for intravenous alteplase, were subdivided into 2 groups (40 patients in each group). Patients were thrombolysed at a dose of 0.6 mg/kg in the first group and 0.9 mg/kg in the second group. Both groups were compared in regard to safety and outcome. Safety was expressed by the rate of symptomatic intracranial hemorrhage (SICH) and 3 months mortality, while outcome was expressed by favorable outcomes at three months (modified Rankin Scale [mRS] of 0 to 2).Results: In the first group, 69.2% (n=27) achieved favorable outcomes at 90 days compared with 64.1% (n=25) in the second group (p=0.631). Ninety-day mortality was 5% (n=2) in the first group versus 2.5% (n=1) in the second group (p=0.556). Symptomatic intracranial hemorrhage was noted in 3 patients in the second group and zero patients in the first group (p=0.077).Conclusion: Low-dose alteplase could be a practical alternative for Egyptian populations with acute ischemic stroke especially in 3 to 4.5 hours window.