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Updated: May 6, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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The treatment effect across ASPECTS in acute ischemic stroke: Analysis from the AcT trial
Chitapa Kaveeta1,2, Ibrahim Alhabli3, Fouzi Bala1,4
1Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Summary
Early ischemic changes on CT scans, measured by Alberta Stroke Program Early CT Score (ASPECTS), predict stroke outcomes. This association was consistent for both tenecteplase and alteplase treatments.
Area of Science:
- Neurology
- Radiology
- Emergency Medicine
Background:
- Early ischemic changes on baseline imaging are crucial for acute stroke decision-making and prognostication.
- The Alberta Stroke Program Early CT Score (ASPECTS) quantifies these early changes.
Purpose of the Study:
- To assess the association between early ischemic changes (ASPECTS) and clinical outcomes in acute anterior circulation stroke.
- To determine if this association differs between intravenous tenecteplase and alteplase treatments.
Main Methods:
- Analysis of data from the phase 3 Alteplase compared to Tenecteplase (AcT) trial.
- Inclusion of patients with anterior circulation stroke, assessing ASPECTS, modified Rankin Scale (mRS), symptomatic intracerebral hemorrhage (sICH), and mortality.
- Use of mixed-effects logistic regression to evaluate the association of ASPECTS with outcomes and potential modification by thrombolytic type.
Main Results:
- A one-point decrease in ASPECTS was linked to decreased odds of achieving mRS 0-1 and mRS 0-2, and increased odds of 90-day mortality.
- These associations were consistent across different ASPECTS categories (0-4, 5-7, 8-10).
- Thrombolytic type (tenecteplase vs. alteplase) did not significantly modify the association between ASPECTS and 90-day mRS 0-1 or other outcomes.
Conclusions:
- Lower ASPECTS scores correlate with poorer clinical and safety outcomes in acute stroke patients.
- The prognostic value of ASPECTS regarding clinical outcomes is similar for both alteplase and tenecteplase treatments.
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