Rationale for testing thrombolysis in acute ischaemic stroke. MAST Group

Stroke is an important health problem in developed countries, being a common cause of death and disability. Prognosis is poor for hospitalised stroke patients, with a 30-day mortality rate of 20-30%, and 30% of the survivors remaining severely disabled. Based on results from experimental animal studies it is thought that early intervention will improve the patients' prognosis. Thrombolytic therapy has been shown to reduce mortality in patients with acute myocardial infarction, and several trials aim to assess its efficacy in patients with acute cerebral infarction. Although many clinical trials have been performed to address this problem, none have provided a clear answer, either because the sample size was insufficient, or by modern standards, the methodology used was not adequate. The Multicenter Acute Stroke Trials (MAST) has been designed to assess the safety and efficacy of thrombolytic therapy with streptokinase for this indication.