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AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

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AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hocent for Healthcare Professionals From the American Heart Association/American Stroke Associationfrom hBp://sỉroke.ahjyoun»13.ocg’’ bỉ' guest on Januar

y 11,2017The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists.Endorsed by the American Associ AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

ation of Neurological Surgeons and Congress of Neurological SurgeonsBart M. Demaerschalk. MD. MSc. FRCPC. FAHA. Chair:Dawn o. Kleindorfer. MD. FAHA. V

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

ice-Chair: Opeolu M. Adeoye. MD. MS. FAHA: Andrew M. Demchuk. MD: Jennifer E. Fugate. DO; James c. Grotta. MD; Alexander A. Khalessi. MD. MS. FAHA: El

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hocith. MD. MPH. FAHA: on behalf of the American Heart Association Stroke Council and Council on Epidemiology and PreventionPurpose—To critically review

and evaluate the science behind individual eligibility criteria (indication/inelusion and contraindications/exclusion criteria) for intravenous recomb AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

inant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow US to better inform stroke providers of quanti

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

tative and qualitative risks associated with altcplasc administration under selected commonly and uncommonly encountered clinical circumstances and to

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc improve outcomes after stroke.Methods—Writing group members were nominated by the committee chair on the basis of their previous work in relevant top

ic areas and were approved by the American Heart Association StrokeijCouneirs Scientific Statement Oversight Committee and the American Henn Associati AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

on's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, mvibid

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

ity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing e

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc. All members of the writing group had the opportunity to comment on and approved the final version of this document. The document underwent extensive

American Heart Association internal peer review. StrokeThe American Heart Association makes every effort to avoid any actual or potential conflicts o AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

f interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. S

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

pecifically, all members of the w riling group arc required to complete 31X1 submit a Disclosure Questionnaire showing all such relationships that mig

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hocting Committee on September 24. 2015. and the American Heart Association Executive Committee on October 5. 2015. A copy of the document IS available a

l http://my.amencanheart.org/statements by selecting either the "By Topic" link or the "By Publication Dale- link. To purchase additional reprints, ca AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

ll 843-216-2533 or e-mail kelle nimsay^ wolterskluwer.com.The online-only Data Supplement, which contains literature search strategies and Figures A.

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

B. and c. Is available with this article al http://cire. uhajoumats.or&'lookup'suppi/diH: in. I Ifcl/M R.mMXMXNXXXMMXMNr^lM'l.The American Heart Assoc

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hocy El. Palesch YY. Pnibhakaran s. Saposnik G. Saver JL. Smith EE; on behalf of the American Heart Association Stroke Council and Council on Epidemiolog

y and Prevention. Scientific rationale for the inclusion and exclusion criteria for intravenous altepla.se in acute ischemic stroke: a statement for h AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

ealthcare professionals from the American Heart Associafion/American Stroke Association Stroke 2OI6;47:XXX-XXX.Expert peer review of AHA Scientific St

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

atements is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit http://my.americanheart.o<

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hocof this document are not permitted without the express permission of live American Heart Association. Instructions for obtaining permission are locate

d at hllpy/ww w.lveart.org/HEARTORG/GeneraliCopyright-Pcrmission-Guidelincs_UCM_30(>404_Arliclc.j.5p. A link to the "Copyright Permissions Request For AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

m" appears on the right side of the page.Ô 2015 American Heart Association, Inc.Stroke Is available at hltp://slroke.ahaj<>unuils.<>qcDOI: 10.1 l61>'S

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

TR.lMKHMHHMI0tKHMHJ86/2 Stroke February 2016Council Leadership review, and Scientific Statements Oversight Committee review before consideration and a

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hocevident that the levels of evidence supporting individual exclusion criteria for intravenous alteplase vary widely. Several exclusionary criteria have

already undergone extensive scientific study such as the deal- benefit of aheplase treatment in elderly stroke patients, those with severe stroke, th AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

ose with diabetes mellitus and hyperglycemia, and those with minor early ischemic changes evident on computed tomography. Some exclusions such as rece

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

nt intracranial surgery are likely based on common sense and sound judgment and arc unlikely to ever be subjected to a randomized, clinical trial to e

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoces not only with the evidence base behind it but also with the frequency of the exclusion within the stroke population, the probability of coexistence

of multiple exclusion factors in a single patient, and the variation in practice among treating clinicians. [Stroke. 2016:47:00-00. DOI: 10.1161/STR. AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

0000000000000086.1Key Words: AHA Scientific Statements ■ brain ischemia ■ cerebral infarction ■ fibrinolytic agents ■ stroke■ thrombolytic therapy ■ (

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

issue plasminogen activatorDownloaded fiom http: suoke.ahajMiinals.oig by guest OU JaiUkvy 11. 2017For our exclusion criteria, we elected to focus onl

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hocUS Food and Drug Administration (FDA) package insert, specifically for the only tissue-type plasminogen activator licensed for use in acuteischemic st

roke, alteplase. We did not include international guidelines or other international governmental restrictions on the use of alteplase because it was b AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

eyond the scope of this document. However, we included data from international studies in our review of the literature for each exclusion. Literature

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

search Strategies are publis s,an online-only Data Supplement.We have also intentionally focusc on any or all types of thrombolytic agent?, trated on

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hocates. Although some hospital and quality registry estimates of altcplase treatment rates can range as high as 20% to 30%,'M national estimates of use

have ranged only from 3% to 5% since 2004.910 Although these rates of treatment are quite low. they are improving slowly over time. This low use IS li AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

kelyattributable to a number of reasons, including the paucity of community public education abiMU recognition and response to acute stroke symptoms a

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

nd signs, the slow adoption of the medication in the medical community, and the complexity of huge system changes at tile hospital level iChat are nec

AHA/ASA Scientific StatementScientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Stateme

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc for low treatment is the low eligibility rate for thisncr.controversies and approvals for these different approaches arc many and currently arc not a

s generalizable as the FDA-approved intravenous administration of alteplase.Recommendations were formulated with the use of standard AHA criteria (Tab AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

les 1 and 2). All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document.

AHA ASA acute stroke alteplase rTPA update 2016 khotailieu y hoc

The document underwent extensive AHA internal peer review. Stroke Council Leadership review, and Scientific Statements Oversight Committee review befo

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