Related Experiment Video

Updated: Oct 15, 2026

Prehospital Thrombolysis: A Manual from Berlin
05:52

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

Streptokinase in acute ischemic stroke: an individual patient data meta-analysis : The Thrombolysis in Acute Stroke

C Cornu1, F Boutitie, L Candelise

  • 1Service de Pharmacologie Clinique EA 643, Claude Bernard University, Lyon, France. Catherine.Cornu@upcl.univ-lyon1.fr

Stroke
|July 8, 2000
PubMed

Insights

Pooling data from acute ischemic stroke trials revealed that streptokinase treatment was not significantly affected by delay, patient risk, or CT signs. However, concomitant aspirin use dramatically increased mortality, suggesting its avoidance in future trials.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Acute ischemic stroke treatment with streptokinase was halted in major trials due to safety concerns.
  • The Thrombolysis in Acute Stroke Pooling Project (TAS-PP) was initiated to analyze pooled data from multiple streptokinase trials.

Purpose of the Study:

  • To identify factors influencing the efficacy and safety of streptokinase in acute ischemic stroke.
  • To analyze aggregate data from randomized controlled trials to understand treatment response variations.

Main Methods:

  • Individual patient data from four major randomized controlled trials (ASK, MAST-E, MAST-I, Glasgow) were pooled.
  • Multivariate modeling was employed to assess interactions between treatment effects and various patient/treatment factors.
  • Outcomes analyzed included 10-day death, death/disability, and death alone at 3 or 6 months.

Main Results:

  • Analysis of 1292 patients (653 streptokinase, 639 control) showed no statistically significant effect of treatment delay on outcomes.
  • Concomitant aspirin use in streptokinase-treated patients was associated with a significant increase in excess mortality (91% vs. 17%, P=0.005).
  • Early CT scan findings did not exacerbate the detrimental effects of streptokinase.

Conclusions:

  • Few factors were found to significantly influence streptokinase response in acute ischemic stroke.
  • Recommendations for future trials include earlier administration, potentially lower streptokinase doses, and strict avoidance of concomitant aspirin.
Abstract

Related Concept Videos

Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...