@article {Yousvn-2017-000106, author = {Shoujiang You and Anubhav Saxena and Xia Wang and WeeYong Tan and Qiao Han and Yongjun Cao and Chun-Feng Liu}, title = {Efficacy and safety of intravenous recombinant tissue plasminogen activator in mild ischaemic stroke: a meta-analysis}, elocation-id = {svn-2017-000106}, year = {2018}, doi = {10.1136/svn-2017-000106}, publisher = {BMJ Specialist Journals}, abstract = {The benefits and safety of intravenous recombinant tissue plasminogen activator (IV-tPA) for patients with mild ischaemic stroke (MIS) are still unclear. The objective of this meta-analysis was to evaluate the efficacy and safety of IV-tPA as treatment for patients with MIS. We performed a systematic literature search across MEDLINE, Embase, Central, Global Health and Cumulative Index to Nursing and Allied Health Literature (CINAHL) , from inception to 10 November 2016, to identify all related studies. Where possible, data were pooled for meta-analysis with odds ratio (OR) and corresponding 95\% confidence interval (CI) using the fixed-effects model. MIS was defined as having National Institutes of Health Stroke Scale score of <=6. We included seven studies with a total of 1591 patients based on the prespecified inclusion and exclusion criteria. The meta-analysis indicated a high odds of excellent functional outcome based on the modified Rankin Scale or Oxfordshire Handicap Score 0{\textendash}1 (OR=1.43; 95\% CI 1.14 to 1.79; P=0.002, I2=35\%) in patients treated with IV-tPA compared with those not treated with IV-tPA (74.8\% vs 67.6\%). There was a high risk of symptomatic intracranial haemorrhage (sICH) with IV-tPA treatment (OR=10.13; 95\% CI 1.93 to 53.02; P=0.006, I2=0\%) (1.9\% vs 0.0\%) but not mortality (OR=0.78; 95\% CI 0.43 to 1.43; P=0.43, I2=0\%) (2.4\% vs 2.9\%). Treatment with IV-tPA was associated with better functional outcome but not mortality among patients with MIS, although there was an increased risk of sICH. Randomised trials are warranted to confirm these findings.}, issn = {2059-8688}, URL = {https://svn.bmj.com/content/early/2018/01/05/svn-2017-000106}, eprint = {https://svn.bmj.com/content/early/2018/01/05/svn-2017-000106.full.pdf}, journal = {Stroke and Vascular Neurology} }