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For: Chao AC, Teng MMH, Chung CP, Weng HY, Chen YY, Yang FY, Wang LM, Hu HH. Preliminary efficacy report of a novel thrombolytic agent for acute ischaemic stroke within a 5-hour window. CNS Drugs 2007;21:937-46. [PMID: 17927297 DOI: 10.2165/00023210-200721110-00005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]

For:	Chao AC, Teng MMH, Chung CP, Weng HY, Chen YY, Yang FY, Wang LM, Hu HH. Preliminary efficacy report of a novel thrombolytic agent for acute ischaemic stroke within a 5-hour window. CNS Drugs 2007;21:937-46. [PMID: 17927297 DOI: 10.2165/00023210-200721110-00005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]

Number

Cited by Other Article(s)

Ho BL, Chen CF, Lin RT, Liu CK, Chao AC. Clinical implication of hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator. Neurol Sci 2016;37:1799-1805. [DOI: 10.1007/s10072-016-2667-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 07/07/2016] [Indexed: 10/21/2022]

Chao AC, Liu CK, Chen CH, Lin HJ, Liu CH, Jeng JS, Hu CJ, Chung CP, Hsu HY, Sheng WY, Hu HH. Different doses of recombinant tissue-type plasminogen activator for acute stroke in Chinese patients. Stroke 2014;45:2359-65. [PMID: 24994721 DOI: 10.1161/strokeaha.114.005245] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]

Affiliation(s)

A-Ching Chao From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.).
Ching-Kuan Liu From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Chih-Hung Chen From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Huey-Juan Lin From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Chung-Hsiang Liu From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Jiann-Shing Jeng From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Chaur-Jong Hu From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Chih-Ping Chung From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Hung-Yi Hsu From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Wen-Yung Sheng From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.)
Han-Hwa Hu From the Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (A.-C.C., C.-K.L.); Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (C.-H.C.); Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan (H.-J.L.); Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H.L.); Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan (C.-J.H., H.-H.H.); Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C.-P.C., W.-Y.S.); and Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan (H.-Y.H.).

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HTUPA as a new thrombolytic agent for acute myocardial infarction: A multicenter, randomized study. Int J Cardiol 2014;172:326-31. [DOI: 10.1016/j.ijcard.2013.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 10/23/2013] [Accepted: 12/14/2013] [Indexed: 11/23/2022]

Liang YG, Liu P, Gao HZ, Li HY, Hao GT, Wang XF, Zhang XG, Meng QY, Liu ZY. Pharmacokinetics and safety of a new bioengineered thrombolytic agent, human tissue urokinase type plasminogen activator in Chinese healthy volunteers. Eur J Drug Metab Pharmacokinet 2010;35:97-102. [DOI: 10.1007/s13318-010-0019-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Accepted: 11/30/2010] [Indexed: 11/30/2022]

Chao AC, Hsu HY, Chung CP, Liu CH, Chen CH, Teng MMH, Peng GS, Sheng WY, Hu HH. Outcomes of thrombolytic therapy for acute ischemic stroke in Chinese patients: the Taiwan Thrombolytic Therapy for Acute Ischemic Stroke (TTT-AIS) study. Stroke 2010;41:885-90. [PMID: 20224056 DOI: 10.1161/strokeaha.109.575605] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]

Abstract

BACKGROUND AND PURPOSE

The safety and efficacy of alteplase for ischemic stroke has not been examined in Chinese patients. We assessed the safety and efficacy of alteplase for acute ischemic stroke in daily clinical practice in Taiwan.

METHODS

A prospective, multicenter, observational study was conducted in Taiwan from December 2004 to July 2008. Eligible patients (241) receiving alteplase were recruited and divided into 2 groups: standard dose (0.90 + or - 0.02 mg/kg, n=125) and lower dose (0.72 + or - 0.07 mg/kg, n=116). Primary outcome measures were safety: symptomatic intracerebral hemorrhage and death within 3 months. The secondary outcome measure was efficacy a modified Rankin scale of 0 to 2 after 3 months.

RESULTS

The standard-dose group had higher rates of symptomatic intracerebral hemorrhage using National Institute of Neurological Diseases and Stroke, European Cooperative Acute Stroke Study, and Safe Implementation of Thrombolysis in Stroke-Monitoring Study definitions (10.4% versus 5.2%, 8.0% versus 2.6%, and 5.6% versus 1.7%, respectively) and mortality within 3 months (12.8% versus 6.9%), twice that of the lower-dose group. This pattern was more prominent in older patients. Significantly higher rates of symptomatic intracerebral hemorrhage per European Cooperative Acute Stroke Study (15.4% versus 3.3%, P=0.0257) and mortality (21.1% versus 5.0%, P=0.0099) and significantly lower independence rate (32.6% versus 53.6%, P=0.0311) were observed among patients > or = 70 years old receiving the standard dose than those receiving the lower dose.

CONCLUSIONS

This study suggests that the standard dose of 0.9 mg/kg alteplase may not be optimal for treating aged Chinese patients. However, the dose of recombinant tissue plasminogen activator for ischemic stroke in Chinese patients should be based on more broad and convincing evidences and randomized trials of lower versus higher doses are needed.

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Balu S. Differences in psychometric properties, cut-off scores, and outcomes between the Barthel Index and Modified Rankin Scale in pharmacotherapy-based stroke trials: systematic literature review. Curr Med Res Opin 2009;25:1329-41. [PMID: 19419341 DOI: 10.1185/03007990902875877] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]

Abstract

OBJECTIVE

Review published clinical trial studies on pharmacological treatment of stroke using both the Barthel Index (BI) and Modified Rankin Scale (MRS) as outcome measures, and to highlight the differences in psychometric properties and cut-off scores through a systematic review.

METHODS

A systematic literature search on stroke studies involving a pharmacological treatment was conducted between 1955-2008. Key words included Barthel index, Rankin, modified Rankin, pharmacotherapy, validity, reliability, responsiveness, sensitivity, specificity, outcomes, psychometrics, prediction, randomized clinical trials, analysis, and stroke. All search terms were limited to Medical Subjects Headings (MESH) terms, English-language abstracts, and human subjects.

RESULTS

Overall, 44 studies were identified, six studies comparing the psychometric properties of the BI and the MRS, 24 studies on use of both the BI and the MRS in clinical stroke trials involving a pharmacological treatment, and 14 studies reviewed the cut-off scores and statistical issues related to scale selection. Most studies measured outcomes at 90 days after initiating therapy although differences were observed in this lag time. There was inconsistency in cut-off points used for both scales in the studies. There was no apparent relation between time to initiation of stroke therapy and outcomes measured by the BI and the MRS. The time window ranged from 3 hours to 72 hours although most of the studies reported outcomes after therapy initiation within 3-6 hours of stroke onset. BI may not be an appropriate scale to measure treatment effects due to the inherent ceiling and floor effects. Use of total distribution scores on the scales rather that dichotomizing or trichotomizing the scales has been favored recently. In mild to moderate stroke patients, the MRS seems to detect small and significant treatment effect changes as compared to the BI. Since most stroke studies try to exhibit the effects of treatment within 3 hours after symptom onset, the MRS might be more relevant to clinicians and patients receiving early intervention. Key limitations of this review are absence of studies that might have been identified through databases other than PubMed and MEDLINE and exclusion of non-pharmacological stroke trials that used the BI and the MRS for outcome measurement.

CONCLUSIONS

Despite the lack of uniformity in the cut-off points used in the trials, the follow-up time after administration of therapy, and the amount of time within which treatment is initiated after onset of stroke symptoms, the MRS seems to be more sensitive and responsive as compared to the BI in measuring stroke disability. However, more studies are required to differentiate the BI and the MRS that would help in selecting a scale that would appropriately capture outcomes among stroke patients.

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