Intravenous recombinant tissue plasminogen activator for acute stroke in Poland: an analysis based on the Safe Implementation of Thrombolysis in Stroke (SITS) Registry

Acta Neurol Scand. 2010 Oct;122(4):229-36. doi: 10.1111/j.1600-0404.2009.01294.x. Epub 2009 Nov 16.

Abstract

Objectives: Intravenous thrombolysis was conditionally approved in the European Union (EU) in 2002, under the requirement of entering all patients into Safe Implementation of Thrombolysis in Stroke - Monitoring Study (SITS-MOST). Countries not belonging to the EU by 2002, i.e. Poland were invited to enter data into the SITS International Stroke Thrombolysis Registry (SITS-ISTR). The aim of this study is to compare the safety and efficacy of thrombolysis in the Polish SITS-ISTR stroke patient population with patients registered in SITS-MOST.

Methods: 481 patients in Poland were reported between 2003 and 2007. Baseline and outcome data of Polish patients were compared with SITS-MOST.

Results: Most of the baseline characteristics did not differ between the groups. The most important was the onset-to-needle and door-to-needle times were significantly longer in Polish patients, 150 vs 136 min and 82 vs 68 min, respectively (P < 0.001). The symptomatic intracranial haemorrhage and independence rates at 3 months were similar in both populations. Polish patients had a significantly higher 3-month mortality rate, 18.6% vs 11.3% (P < 0.001).

Conclusions: Because of higher mortality the study implies the need to improve the organization of thrombolysis services and provides the rationale to continue the monitoring of treatment in Poland.

MeSH terms

  • Aged
  • Analysis of Variance
  • Atrial Fibrillation / complications
  • Brain Ischemia / complications
  • Brain Ischemia / drug therapy*
  • Brain Ischemia / mortality
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Hypertension / complications
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Poland
  • Registries
  • Stroke / complications
  • Stroke / drug therapy*
  • Stroke / mortality
  • Thrombolytic Therapy / methods
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / therapeutic use*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator