EVALUATION OF ALTEPLASE ADMINISTRATION ACCURACY AND CLINICAL OUTCOMES IN ACUTE ISCHEMIC STROKE PATIENTS WITH THROMBOLYSIS THERAPY AT X HOSPITAL IN 2024.
Abstract
This study aimed to evaluate the timeliness of alteplase administration and clinical outcomes in acute ischaemic stroke patients at Hospital X in 2024. Using a retrospective analytic observational design, data were collected from patients' medical records with a focus on the timeliness of alteplase administration (<4.5 hours) and its impact on clinical outcomes. All patients (100%) received alteplase in a timely manner, according to AHA guidelines, with none receiving therapy after 4.5 hours. The results showed that the timeliness of alteplase administration had a significant effect on clinical outcome, with 90.9% of patients achieving a positive outcome. alteplase administration within the appropriate time window is critical for the clinical recovery of acute ischaemic stroke patients.
Keywords:
Evaluation of alteplase administration, Acute ischemic stroke, Thrombolysis therapy, Clinical outcomes.
References
[1] Allen, “Terapi Tissue Plasminogen Activator untuk Stroke Iskemik Akut,” Cermin Dunia Kedokt., vol. 50, no. 3, pp. 167–170, 2023, doi: 10.55175/cdk.v50i3.661.
[2] M. A. Akbar and R. Ferdi, “Pelayanan Home Care Dalam Meningkatkan Kemandirian Keluarga Merawat Anggota Keluarga Dengan Stroke,” Cendekia Med. J. Stikes Al-Ma`arif Baturaja, vol. 7, no. 2, pp. 115–123, 2022, doi: 10.52235/cendekiamedika.v7i2.189.
[3] B. Rilianto, “Terapi Trombolitik Intravena untuk Stroke Iskemik Akut - Hambatannya di Negara Berkembang,” Cermin Dunia Kedokt., vol. 43, no. 12, pp. 946–951, 2016.
[4] S. G. Bell, “Recombinant tissue plasminogen activator.,” Neonatal Netw., vol. 15, no. 6, pp. 13–18, 1996, doi: 10.1007/978-3-319-57111-9_2206.
[5] P. Sivanandy, B. Thomas, V. Krishnan, and S. Arunachalam, Safety and Efficacy of Thrombolytic Therapy Using rt-PA (Alteplase) in Acute Ischemic Stroke. Egypt: Hindawi Pub. Corp., 2011. doi: 10.5402/2011/618624.
[6] K. A. Dancsecs, M. Nestor, A. Bailey, E. Hess, E. Metts, and A. M. Cook, “Identifying errors and safety considerations in patients undergoing thrombolysis for acute ischemic stroke,” Am. J. Emerg. Med., vol. 47, no. 1, pp. 90–94, 2021, doi: https://doi.org/10.1016/j.ajem.2021.03.043.
[7] B. M. Demaerschalk et al., “Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.,” Stroke, vol. 47, no. 2, pp. 581–641, Feb. 2016, doi: 10.1161/STR.0000000000000086.
[8] J. Liu, X. Hu, Y. Wang, X. Guan, J. Chen, and H. Liu, “The safety and effectiveness of early anti-platelet therapy after alteplase for acute ischemic stroke: A meta-analysis.,” J. Clin. Neurosci. Off. J. Neurosurg. Soc. Australas., vol. 91, pp. 176–182, Sep. 2021, doi: 10.1016/j.jocn.2021.07.002.
[9] Hidayat, Faqih, et al. "Perbandingan luaran klinis pada pasien stroke iskemik fase akut dengan satu atau lebih faktor risiko". Jurnal Neuroanestesi Indonesia, vol. 11, no. 1, 2022, p. 7-14. https://doi.org/10.24244/jni.v11i1.345
[10] Mahendrakrisnna, Daniel, et al. "Hubungan kadar trigliserida dalam darah terhadap luaran klinis penderita stroke iskemik akut". Callosum Neurology, vol. 4, no. 2, 2022, p. 66-72. https://doi.org/10.29342/cnj.v4i2.143
[11] Vitt JR, Trillanes M, Hemphill JC. Management of blood pressure during and after recanalization therapy for acute ischemic stroke. Am J Emerg Med. 2007;25(1):32–8.
[12] Retnaningsih, R., & Hendartono, T. K. "Profil Pasien Stroke Iskemik Akut dengan Terapi Recombinant Tissue Plasminogen Activator di RSUP Dr. Kariadi Semarang." Neurona, vol. 36, no. 4, 2019, pp. 280–285.
[13] Oktayanti, Leny, et al. “Knowledge, Attitude, and Compliance with Hypertension Patients at The Manggis I Karangasem Health Centre.” Jurnal Farmasi Indonesia, vol. 16, no. 1, 2024, doi:10.35617/jfionline.v16i1.171.
[14] World Health Organization. A Global Brief on Hypertension: Silent Killer, Public Health Crisis. WHO, 2013, www.who.int/about/licensing/copyright_form/en/index.html.
[15] Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia 2018. Kementerian Kesehatan RI, 2019.
[16] Heller, Daniel J., and Sandeep P. Kishore. “Closing the Blood Pressure Gap: An Affordable Proposal to Save Lives Worldwide.” BMJ Global Health, vol. 2, no. 3, 2017, doi:10.1136/bmjgh-2017-000236.
[17] Reynolds, Andrew N., et al. “Dietary Fibre in Hypertension and Cardiovascular Disease Management: Systematic Review and Meta-Analyses.” BMC Medicine, vol. 20, no. 139, 2022, doi:10.1186/s12916-022-02328-x.
[18] Ma, G., et al. “The Status of Medication Literacy and Associated Factors of Hypertensive Patients in China: A Cross-Sectional Study.” Internal and Emergency Medicine, vol. 15, no. 3, 2020, pp. 409–19, doi:10.1007/s11739-019-02187-0.
[19] Puddey, Ian B., et al. “Alcohol and Hypertension – New Insights and Lingering Controversies.” Current Hypertension Reports, vol. 21, no. 10, 2019, p. 79, doi:10.1007/s11906-019-0984-1.
[2] M. A. Akbar and R. Ferdi, “Pelayanan Home Care Dalam Meningkatkan Kemandirian Keluarga Merawat Anggota Keluarga Dengan Stroke,” Cendekia Med. J. Stikes Al-Ma`arif Baturaja, vol. 7, no. 2, pp. 115–123, 2022, doi: 10.52235/cendekiamedika.v7i2.189.
[3] B. Rilianto, “Terapi Trombolitik Intravena untuk Stroke Iskemik Akut - Hambatannya di Negara Berkembang,” Cermin Dunia Kedokt., vol. 43, no. 12, pp. 946–951, 2016.
[4] S. G. Bell, “Recombinant tissue plasminogen activator.,” Neonatal Netw., vol. 15, no. 6, pp. 13–18, 1996, doi: 10.1007/978-3-319-57111-9_2206.
[5] P. Sivanandy, B. Thomas, V. Krishnan, and S. Arunachalam, Safety and Efficacy of Thrombolytic Therapy Using rt-PA (Alteplase) in Acute Ischemic Stroke. Egypt: Hindawi Pub. Corp., 2011. doi: 10.5402/2011/618624.
[6] K. A. Dancsecs, M. Nestor, A. Bailey, E. Hess, E. Metts, and A. M. Cook, “Identifying errors and safety considerations in patients undergoing thrombolysis for acute ischemic stroke,” Am. J. Emerg. Med., vol. 47, no. 1, pp. 90–94, 2021, doi: https://doi.org/10.1016/j.ajem.2021.03.043.
[7] B. M. Demaerschalk et al., “Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.,” Stroke, vol. 47, no. 2, pp. 581–641, Feb. 2016, doi: 10.1161/STR.0000000000000086.
[8] J. Liu, X. Hu, Y. Wang, X. Guan, J. Chen, and H. Liu, “The safety and effectiveness of early anti-platelet therapy after alteplase for acute ischemic stroke: A meta-analysis.,” J. Clin. Neurosci. Off. J. Neurosurg. Soc. Australas., vol. 91, pp. 176–182, Sep. 2021, doi: 10.1016/j.jocn.2021.07.002.
[9] Hidayat, Faqih, et al. "Perbandingan luaran klinis pada pasien stroke iskemik fase akut dengan satu atau lebih faktor risiko". Jurnal Neuroanestesi Indonesia, vol. 11, no. 1, 2022, p. 7-14. https://doi.org/10.24244/jni.v11i1.345
[10] Mahendrakrisnna, Daniel, et al. "Hubungan kadar trigliserida dalam darah terhadap luaran klinis penderita stroke iskemik akut". Callosum Neurology, vol. 4, no. 2, 2022, p. 66-72. https://doi.org/10.29342/cnj.v4i2.143
[11] Vitt JR, Trillanes M, Hemphill JC. Management of blood pressure during and after recanalization therapy for acute ischemic stroke. Am J Emerg Med. 2007;25(1):32–8.
[12] Retnaningsih, R., & Hendartono, T. K. "Profil Pasien Stroke Iskemik Akut dengan Terapi Recombinant Tissue Plasminogen Activator di RSUP Dr. Kariadi Semarang." Neurona, vol. 36, no. 4, 2019, pp. 280–285.
[13] Oktayanti, Leny, et al. “Knowledge, Attitude, and Compliance with Hypertension Patients at The Manggis I Karangasem Health Centre.” Jurnal Farmasi Indonesia, vol. 16, no. 1, 2024, doi:10.35617/jfionline.v16i1.171.
[14] World Health Organization. A Global Brief on Hypertension: Silent Killer, Public Health Crisis. WHO, 2013, www.who.int/about/licensing/copyright_form/en/index.html.
[15] Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia 2018. Kementerian Kesehatan RI, 2019.
[16] Heller, Daniel J., and Sandeep P. Kishore. “Closing the Blood Pressure Gap: An Affordable Proposal to Save Lives Worldwide.” BMJ Global Health, vol. 2, no. 3, 2017, doi:10.1136/bmjgh-2017-000236.
[17] Reynolds, Andrew N., et al. “Dietary Fibre in Hypertension and Cardiovascular Disease Management: Systematic Review and Meta-Analyses.” BMC Medicine, vol. 20, no. 139, 2022, doi:10.1186/s12916-022-02328-x.
[18] Ma, G., et al. “The Status of Medication Literacy and Associated Factors of Hypertensive Patients in China: A Cross-Sectional Study.” Internal and Emergency Medicine, vol. 15, no. 3, 2020, pp. 409–19, doi:10.1007/s11739-019-02187-0.
[19] Puddey, Ian B., et al. “Alcohol and Hypertension – New Insights and Lingering Controversies.” Current Hypertension Reports, vol. 21, no. 10, 2019, p. 79, doi:10.1007/s11906-019-0984-1.
Published
2025-11-28
Section
Articles
2.jpg)
