EFFICACY OF LOW-DOSE THROMBOLYSIS WITH INTRAVENOUS ALTEPLASE WITHIN 6 H OF ACUTE ISCHEMIC STROKE ONSET: EVIDENCE FROM SINGLE REFERRAL CENTER IN INDONESIA

Al Rasyid; Salim Harris; Mohammad Kurniawan; Taufik Mesiano; Rakhmad Hidayat; Herqutanto; Meity Asyari Rahmadhani

doi:10.22159/ijpps.2019v11i8.34029

Authors

Al Rasyid Department of Neurology, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Salim Harris Department of Neurology, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Mohammad Kurniawan Department of Neurology, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Taufik Mesiano Department of Neurology, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Rakhmad Hidayat Department of Neurology, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Herqutanto Department of Community Medicine, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia
Meity Asyari Rahmadhani Department of Neurology, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia

DOI:

https://doi.org/10.22159/ijpps.2019v11i8.34029

Keywords:

Efficacy, Thrombolysis, Alteplase, Ischemic stroke, Indonesia

Abstract

Objective: This study evaluated the efficacy of thrombolysis with 0.6 mg/kg intravenous alteplase for acute ischemic stroke patients within 6 h of stroke onset.

Methods: This cross-sectional study collected data of patients with ischemic stroke received intravenous thrombolytic therapy with 0.6 mg/kg alteplase within 6 h of onset in Cipto Mangunkusumo General Hospital (Rumah Sakit Cipto Mangunkusumo [RSCM]) between November 2014 and August 2017. Efficacy of the thrombolytic therapy was evaluated using the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). NIHSS evaluated on 24 h and 7 d post thrombolytic therapy portrayed clinical outcomes of patients while mRS evaluated on day 30 post-thrombolysis portrayed the functional outcome of patients.

Results: The median NIHSS score decreased on 24 h and 7 d post-thrombolysis. 33.3% patients experienced a reduction of NIHSS score ≥4 on 24 h post thrombolytic therapy. On day 7 following thrombolysis, 57.4% patients had a good clinical outcome. On day 30 follow-up, 55.6% patients had a good functional outcome.

Conclusion: Thrombolysis using 0.6 mg/kg intravenous alteplase within 6 h of onset is effective for acute ischemic stroke patients.

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