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(Stroke. 2006;37:312.)
© 2006 American Heart Association, Inc.

Advances in Stroke 2005

Thrombolytics, Anticoagulants, and Antiplatelet Agents

From the University of Heidelberg, Germany.

Correspondence to Peter A. Ringleb, Im Neuenheimer Feld 400, Heidelberg, Germany 69120. E-mail peter_ringleb@med.uni-heidelberg.de

Key Words: antihypertensive agents • anticoagulants • thrombolytic therapy

An extract of the first 250 words of the full text is provided, because this article has no abstract.

More than 250 articles regarding thrombolytic therapy in acute ischemic stroke were published in the first 10 months of 2005 (Source PubMed). In this section we will focus on some reports that directly affect and improve the treatment of stroke patients, that led to further phase III trials, or that represent a great disappointment after several years of investigation.

Thrombolytics

The key publication on thrombolytic therapy in acute ischemic stroke using recombinant tissue plasminogen activator was published almost 10 years ago, which led to the approval of this drug in many countries.¹ Since then, considerable knowledge has been gained about the risks and benefits of thrombolytic therapy. However, 1 major concern is still the limited time window of 3 hours. Many studies have been conducted to extend this time window without increasing the risk for the patients. In addition, more pathophysiologically oriented imaging techniques, such as diffusion- and perfusion-weighted imaging, seemed to be able to detect tissue at risk for further infarction. In January 2005, the results of the Desmoteplase In Acute Ischemic Stroke trial (DIAS) were published.² DIAS was a dose-finding, phase II, randomized trial designed to evaluate the safety and efficacy of intravenous desmoteplase, a highly fibrin-specific thrombolytic agent, administered within 3 to 9 hours of ischemic stroke onset in patients with perfusion/diffusion mismatch on MRI. It was the first randomized, double-blind, placebo-controlled thrombolysis trial using MRI-based criteria for patient selection and also as an end point. The efficacy end points were rate of reperfusion on MRI after 4 . . . [Full Text of this Article]

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