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(Circulation. 1996;94:1195-1196.)
© 1996 American Heart Association, Inc.

Articles

Meeting Highlights

American Heart Association 21st International Joint Conference on Stroke and Cerebral Circulation, San Antonio, Tex, January 25-27, 1996

James J. Ferguson, MD

St Luke's Episcopal Hospital, Texas Heart Institute, Baylor College of Medicine, University of Texas Health Science Center at Houston.

Correspondence to James J. Ferguson, MD, St Luke's Episcopal Hospital, Texas Heart Institute, 1101 Bates Ave, Suite O-510, Houston, TX 77030.

	Thrombolytic Treatment of Acute Stroke

 
One of the major highlights of the meeting was the well-publicized presentation of the National Institute of Neurological Disorders and Stroke (NINDS) TPA trial, which demonstrated that in appropriately selected stroke patients, treatment with TPA (0.9 mg/kg to 90 mg; 10% given as a bolus, 90% infused over 60 minutes) within 3 hours is associated with significantly less residual disability at 3 months than placebo. This study has already been published,¹ but a number of other trials of thrombolytic therapy in acute stroke were also presented.

Dr Marc Hommell, of Grenoble, France, presented the results of the Multicenter Acute Stroke Trial-Europe (MAST-E). MAST-E compared streptokinase (1.5 million U IV over 1 hour) with placebo in acute stroke patients presenting within 6 hours of symptom onset. As originally designed, the trial was to include 600 patients, with efficacy assessed as a composite of death and disability (measured by the Rankin scale, a simplified overall assessment of function). However, the trial was halted prematurely at 310 patients because of an excess of in-hospital mortality in the streptokinase group (46.8% versus 38.3% with placebo). The investigators also noted moderate improvement in disability in stroke survivors treated with streptokinase.

Dr Geoffrey Donnan and Dr Stephen Davis, of Melbourne, Australia, presented the results of the Australian Streptokinase Study. In this study, involving 40 clinical centers in Australia, acute stroke patients were randomized to receive either streptokinase (1.5 million U IV over 60 minutes) or placebo within 4 hours of symptom onset. Both groups received 100 . . . [Full Text of this Article]