Patient outcome in the 5 years following alteplase treatment

This study examined the long-term outcomes associated with intravenous (through a tube into the vein) alteplase (Activase) treatment for ischemic stroke. This study found that roughly one-third of patients involved experienced an excellent outcome after 5 years, particularly younger patients with less initial disability.

Treating an ischemic stroke (stroke due to blockage of blood flow due to a blood clot) as early as possible can improve patient outcomes. Many treatments must be delivered within the first few hours after the stroke occurs. Alteplase, for example, is a treatment that can dissolve blood clots. Alteplase is effective only when it is delivered within 4.5 hours following an ischemic stroke.

While this treatment is known to be effective in the short-term, the longer-term outcomes of patients who received alteplase are not yet known.

The current study followed 155 ischemic stroke patients to determine the long-term outcomes of alteplase. Patients took part in telephone interviews and medical records were examined for up to 5 years following treatment.

After 5 years, 32.9% of patients were considered to have an excellent outcome, based on recovery of physical function and how well they carried out daily activities. Older patients had a 7% decreased likelihood of an excellent outcome. Patients who had higher levels of disability 24 hours after treatment were 19% less likely to have an excellent outcome.

The 5-year mortality rate was 43.9%. Risk of mortality at 5 years was 72% lower for patients with an excellent outcome at 3 months. Stroke recurred in 7.7% of patients.

This study concluded that treatment with alteplase was associated with improved long-term outcomes in roughly one-third of patients, particularly younger patients and those with lower initial levels of disability.