Thrombolysis With Tenecteplase for Minor Disabling Stroke

作者：Yiran Zhang, Brian Buck, Philip A. Barber, Kausik Chatterjee, Brian Clarke, Philip Choi, Gary Hunter, Aravind Ganesh, Sachin Mishra, David Williams, Bruce Campbell, Dar Dowlatshahi, Kenneth Butcher, Kailash Krishnan, M Ivan Wiggam, Timothy Kleinig, Keith W. Muir, Charlotte Zerna, Thalia S. Field, Mayank Goyal, Amy Yu, Christine Roffe, Andrew M. Demchuck, Mark Parsons, Rodrigo Bazán, Sandeep Ankolekar, James Kennedy, Bijoy K. Menon, Jennifer Mandzia, Arthur Pille, Peter J. Kelly, Martha Marko, Nishita Singh, Shabnam Vatanpour, Fabrício Oliveira Lima, Luciana Catanese, MacKenzie Horn, Darshan Ghia, Julia Ferrari, Stefan Greisenegger, Michael D. Hill, Shelagh B. Coutts, TEMPO-2 Investigators, Marina Salluzzi, Nicole Blenkin, Ashley Dueck, Craig Doram, Qiao Zhang, Carol Kenney, Karla J. Ryckborst, Shelly Bohn, Quentin Collier, Frances Taylor, Brendan Cord Lethebe, Carlos A. Molina, Robert G. Hart, David M. Kent, Renée H. Martin, William Whiteley, Anitha Jambula, Kayla Sage, Lana Toussaint, Supriya Save, Julian Lee, Nihay Laham-Karam, Abdulaziz Sultan, Aimen Moussaddy, Akshay Deepak, Amith Sitaram, Andrew Lockey, Andrew Micielli, Ankur Wadhwa, Babawale Arabambi, Brett Graham, Carol Huilian Tham, Chrysi Bogiatzi, Darshan Doshi, Debabrata Chakraborty, Diana Kim, Diego Vásquez, Dilip Singh, Dominic Tse, Emma Harrison, Elliott Smith, Ericka Teleg, Evgenia Klourfeld, Gary Klein, Ivy Sebastian, James Evans, Janka Hegedus, Julie Kromm, Katie Lin, Katrina Hannah D. Ignacio, Kimia Ghavami, Madawi Ismail, Margaret Moores, Marie-Andrée Panzini, Matthew Boyko, Mohammed Almekhlafi, Nancy Newcommon, Nicholas Maraj, Oje Imoukhuede, Ondřej Volný, Peter K. Stys, Philippe Couillard, Piyush Ojha, Prasanna Venkatesan Eswaradass, Raed A. Joundi, Ramana Appireddy, Ravinder Singh, R.M. Asuncion, Ryan T. Muir, Sadanand Dey, Salman Mansoor, Sanchea Wasyliw, Shashank Nagendra, Sherry Hu, Shorog Althubait, Siew Chen, Simerpreet Bal, Stephen van Gaal, Steven Peters, Sucharita Ray, Surbhi Chaturvedi, Suresh Subramaniam, Vivian Fu, Karina Villaluna, Genoveva Maclean, Princess King-Azote, Carson Ma, Alyson Plecash, Colleen Murphy, Johnathon Gorman, Laura Wilson, Lily Zhou, Oscar Benavente, Philip Teal, Samuel Yip, Sharan Mann, Brian Dewar, Michele Demetroff, Rany Shamloul, Rebeccah Beardshaw, Sohail Roberts, Dylan Blaquiere, Grant Stotts, Michel Shamy, Olena Bereznyakova, Robert Fahed, Walid Alesefir, Marie‐Christine Camden, Suzy Lavoie, Annette Haché, Karine Collard, Ariane Mackey, Stéphanie Gosselin-Lefebvre, Steve Verreault, Beth Beauchamp, Lindsay Lambourn, Alexander V. Khaw, Lauren Mai, Luciano A. Sposato, Maria Bres-Bullrich, Reza Azarpazhooh, Sebastián Fridman, Arunima Kapoor, Alisia Southwell, Edith Bardi, Idris Fatakdawala, Maneesha Kamra, Kaitlyn Lopes, Najla Popel, Vanessa Norouzi, Anna Liu, Anne Liddy, Bismah Ghoari, Christine Hawkes, Claire Enriquez, David J. Gladstone, Herbert Alejandro Manosalva Alzate, Houman Khosravani, Julia Hopyan, Keith Sivakumar, Maksim Son, Mark I. Boulos, May AlHamind, Richard H. Swartz, Robert Murphy, Stephanie Reiter, Tess Fitzpatrick, Vinaya Bhandari, Andrew M. Penn, Jennifer Good, Melanie Penn, Melissa Naylor, Sheilah Frost, Leanne K. Casaubon, Anne Cayley, Farhana Akthar, Janice E. Williams, Libby Kalman, Lisa Crellin, R Wiegner, Shoba Singh, Tim Stewart, W. W. K. To, Aleksandra Pikula, Cheryl Jaigobin, Federico Carpani, Frank L. Silver, Helena Janssen, Joanna D. Schaafsma, Martín del Campo, Mohammed A. Alskaini, Phavalan Rajendram, Paige Fairall, Bonny Granfield, Danna Crawford, Juline Jabs, Leah White, Leka Sivakumar, Lori Piquette, Thao D. Nguyen, Ali Zohair Nomani, Amy W. Wagner, Anas Alrohimi, Asif Butt, Atlantic D’Souza, Bikram Prasad Gajurel, Chetan Vekhande, Harsha Kamble, Hayrapet Kalashyan, Mar Lloret, Mowad Benguzzi, Nazeem Arsalan, Noman Ishaque, R. Ashayeriahmadabad, Robert Samiento, Seyed Hosseini, Sharish Kazi, Shubhabrata Das, T. Sugumar, Atif Zafar, Daniel Selchen, Pawel Kostyrko, Alexandra Muccilli, Gustavo Saposnik, Cheyanne Vandervelde, Kanchana Ratnayake, Sue McMillan, Aristeidis H. Katsanos, Ashkan Shoamanesh, Demetrios J. Sahlas, George Medvedev, Vishaya Naidoo, Vesselin Todorov, Hassanain S. Toma, Jaskiran Brar, Myles Horton, Elaine Shand, Sandy Weatherby, Albert Jin, Bryce A. Durafourt, Shirin Jalini, Aaron Gardner, Cassandra Tyson, Emily Junk, Kaitlyn Foster, Kala Bolt, Nicole J. Sylvain, Sharleen Maley, Lilian Urroz, Lissa Peeling, Michael Kelly, Ruth Whelan, Regan Cooley, Jeanne Teitelbaum, Achraf Boutayeb, Angela Moore, Erin L. Cole, Lindsay Waxman, Nadia Ben-Amor, Rick F. Sanchez, Salma Khalil, Ahmad Nehme, C. LEGAULT, Donatella Tampieri, Eric Ehrensperger, Lucy Vieira, Maria Cortes, Michael Angle, Mathew Hannouche, Mohamed Badawy, Karin Werner, Sonja Wieszmuellner, A. Langer, Anna Gisold, Heidemarie Zach, Paulus Rommer, Stefan Macher, Stephan Blechinger, Wolfgang Marik, Wolfgang Series, M. Baumgartinger, Stefan Krebs, Daniel Strbian, Jaana Koski, S. Eirola, Terhi Ivanoff, Anu Erakanto, Laura-Leena Kupari, Gerli Sibolt, Jonatan Panula, Liisa Tomppo, Marjaana Tiainen, Matti Ahlström, N Martinez Majander, Olli Suomalainen, Silja Räty, Christopher Levi, Neil J. Spratt, Enda Kerr, Joanne B. Allen, Lara Kaauwai, Linda Belevski, Michelle Russell, Sally Ormond, Alvin Chew, Andre Loiselle, Angela Royan, Bridget Hughes, Carlos García Esperón, Elizabeth Pepper, Ferdi Miteff, Jiacheng He, Mitchell Lycett, Myintzu Min, Natalia Murray, Nathan Pavey, R. Starling de Barros, Shyam Gangadharan, Sophie Dunkerton, Sophie Waller, Tamara Canento Sánchez, Tom Wellings, Gillian Edmonds, Kerri-Ann Whittaker, Megan Ewing, Phoebe Lee, Rowena Singkang, Amy McDonald, Ângela Barreto Santiago Santos, Christine Shin, David M. Jackson, Jessica Tsoleridis, Laura Fisicchia, Nicola Parsons, Nikitha Shenoy, Shannon D. Smith, Angelos Sharobeam, Anna Balabanski, Ashley Park, Cameron Williams, Davor Pavlin-Premri, Edrich Rodrigues, Fana Alemseged, Felix Ng, Henry Zhao, James Beharry, Jo-Lyn Ng, John Williamson, Joseph K. Wong, K. Li, Michael Kwan, Michael Valente, Nawaf Yassi, Vignan Yogendrakumar, Bailey McNamara, Claire Buchanan, Claire McCarthy, Grace Thomas, Karen Stephens, Mang Chung, Melissa Tang, Naila Pachani, Narelle Stuart, Rose Lee, Tanya Frost, Tessa Busch, Ashwathi Menon, Branko Borojevic, Chris Linton, Edward Callaly, Gayle Garcia, Helen M. Dewey, Jennifer Liu, Jessie Chen, Kara Nowak, Kien Gia To, Nathaniel Lizak, Oneil G. Bhalala, Peter Park, Peter Tan, Rodrigo Martins, Ross Cody, Ryan Forbes, Steven Tu, Suyi Ooi, Yew Dang, Zhiyu Ling, Jennifer Cranefield, Roy Drew, Aaron C. Tan, Craig Kurunawai, Jackson Harvey, Joshua Mahadevan, Lavenia Cagi, Logesh Palanikumar, Nicholas Chia, Rudy Goh, Shaddy El‐Masri, Peter Bailey, Berzenn Urbi, Cheryl Rapier, Haylee Berrill, H C McEvoy, Rachael Dunning, Sumole Kuriakose, Terry Chad, Vincent Sapaen, Arman Sabet, Darshan Shah, Dennis Yeow, Kate Lilley, Kayla Ward, M Mozhy Mahizhnan, Meng H. Tan, Catherine Lynch, Sarah Coveney, Katrina Tobin, John McCabe, Michael Marnane, Stephen Murphy, Margaret Large, Barry Moynihan, Karl Boyle, Estela Sanjuán, Mireia Sanchis, Olalla Pancorbo, Victòria Sala, Lidia García, Álvaro García‐Tornel, Jesús Juega, Jorge Pagola, Katherine Santana, Manuel Requena, Marián Muchada, Marta Olivé‐Gadea, Marta Rubiera, Matías Deck, Noelia Rodríguez, Prudencio Lozano, Sandra Boned, Juan F. Arenillas, Beatriz Pérez‐Gómez, F J Reyes Munoz, Alicia León Gómez, Ana I. Calleja Sanz, Elisa García, G. Valle Peñacoba, María Ramos, M. De Lera Alfonso, Joaquin Leal, Anna Feliu, Laura Pardo, Paula Ramírez, Alan Murillo Hernandez, D Lopez Dominguez, Juan C. Rodríguez, Mikel Terceño Izaga, Montse Reina, Saima Viturro, Urszula Bojaryn, V. Molina, Yolanda Silva Blas, Rachel Wan En Siew, Sherwin Agustin, Christopher Seet, Tian Ming Tu, Alicia Murray, Angela Welch, Kim Hatherley, Nicola C. Day, W. G. J. Smith, Emma MacRae, Shirley Mitchell, Ammad Mahmood, Jennifer Elliot, S. Neilson, Viveka Biswas, Cameron Brown, Robert Simister, Alexandra Lewis, Amy Ashton, Anna J. Black, Anna M.C. Robinson, Annick Williams, Azra Banaras, Cyrille Cahoy, Georgia Raingold, Marilena Marinescu, Ndifreke Atang, Nina Bason, Nina Francia, Riham Muhammad, Sabaa Obarey, Shez Feerick, Yee-Chin Lee, David J. Werring, Richard Perry, Jeethu Joseph, Jithen Benjamin, Lauren Quinn, Monica Jhoots, Rachel Teal, Gary A. Ford, George Harston, Harjit Bains, Ivie Gbinigie, Philip Mathieson, Robert Irons, Ursula G. Schulz, Cai Sim, Elizabeth Hayter, Kate Kennedy, Lauren Binnie, Naomi Priestley, Rebecca J. Williams, Rita Ghatala, Sarah Stratton, Adrian Blight, Liqun Zhang, Angela M. Davies, Heather Duffy, Jean Roberts, John Homer, Karen Roberts, Kate Dodd, Kathryn Cawley, Carmen Martín, Sandra Leason, Susan Cotgreave, Tom Taylor, Arumugam Nallasivan, Syed Haider, Tapas Chakraborty, Tim Webster, Omid Halse, Ana Jiménez Gil, Barry J. Martin, Biji Joseph, Christine Cabrera, Divia Jose, Jackie Man, Jasmin Aquino, Leony Sebastian, Marc F. Österdahl, M Matthew, Naomi Ike, P Bello, Peter Wilding, Rodel Fuentes, Rupal Shah, Sheila Mashate, Tulsi Patel, U Nwanguma, Vaishali Dave, Ahmed El‐Masry, Ambreen Sheikh, Angelo Dawson, Anna Haber, Annabelle Lee, Anthony O’Sullivan, Brian Drumm, Catherine O’Hare, Danielle Roberts, Dheeraj Kalladka, Eleanor Taylor, Elisabeth Rounis, Frederick W. Vonberg, I. H. Jenkins, Jelena Blagojević, Jithin George, Joseph Kwan, Mamoun Saeed, Matthew R. Evans, Michael Haji-Coll, Miho Tsuda, Mohamed Sayed, Narmathey Thanbirajah, Nicholas Winterkron, Oishik Raha, Orsolya Vittay, Rabail Karim, Ruaridh Cameron Smail, Sabaa Gauhar, Sabrina Kalam, Salwa Elmamoun, Sangam Malani, Shyam Kelavkar, Sohaa Jamil, Stephen D. Auger, Tarek Matar, Joanne Hiden, Resti Varquez, Phillip Ferdinand, Ranjan Sanyal, Bernie Smith, Chidiogo Okechukwu, Elieen Fox, Érin Collins, Kerry Courtney, Suzanne Tauro, Cathy Patterson, David McShane, Gerallt Roberts, Jim McIImoyle, Karen McGuire, Patricia Fearon, Patricia Gordon, Mark Willmot, K Isaacs, Katherine Lucas, Linda Smith, Lucie Dews, Michelle Bates, Stacey Lawrence, Susan Heeley, Vruti Patel, Y Chin, Don Sims, Edward Littleton, Jattinder Khaira, Kurdow Nadar, Agnieszka Kieliszkowska, Beatrix Sari, Caroline Domingos Belo, Erika Manolo, John Aeron‐Thomas, Maria Doheny, M Garcia Pardo, Mónica Recamán, Maria Tibajia, Myriam Aissa, Samantha Bayhonan, Staci Conway, Ajay Bhalla, Anushka Engineer, Dimitrios Nouvakis, Evangelia Theochari, F. Boyle, James Teo, Josh King‐Robson, Kar Law, L. Sztriha, Matthew Benger, Mena Farag, Owain Williams, Rana Alnasser Alsukhni, Simon Heller, Salvadeeswaran Meenakshi‐Sundaram, Tian Yu, Yee Mah, George Zachariah, Alex McGovern, Arshi Iqbal, Diana J. Day, J. Mitchell-Douglas, Jobbin Francis, Puja Punjabivaryani, Javier Reyes, Mathide Pauls, M Anonuevo Reyes, Amanda Buck, Amanda Hedstrom, Camille Hutchinson, C. Kirkland, Gwen Wilkes, Jodie Newham, Lucy Fleming, Sheila Cristina Ouriques Martins, Natacha Fleck, Alvaro Franca, Bruna Cristine Chwal, Carolina Oldoni, Gabriel Paulo Mantovani, G. Noll, Laisa Zanella, Marcelo Soma, Thaís Secchi, Wyllians Vendramini Borelli, Octávio Marques Pontes‐Neto, Brunna Rimoli, G. Silva, Leila Aparecida Machado Galvao Mondin, Rodrigo Barbosa Cerantola, Alexandre Kracker Imthon, Atsushi ESAKI, Ana Leticia Amorim de Albuquerque, Andréia Martini Pazini, Carlos Massote Fontanini, Carmen Rubio, Cristiano Milani, Daniel Teixeira dos Santos, Francisco Antunes Dias, Frederico Alves, Guilherme Gualberto Rodrigues, Kamila Santos Ferreira, Marcia Pena Pereira, Matheus Bernardon Morillos, Millene Rodrigues Camilo, Otavio Costa Vincenzi, Renato ds Cruz, Bruno Pegorer Santos, Fernanda Cristina Winckler, Juli Thomaz de Souza, Luana Aparecido Muondo Bonome, Natália Alexandre Ferreira, Daniel Fabiano Barbosa dos Santos, Gabriel Pinheiro Módolo, Julio Cesar dos Santos Moreira, Robson Sarmento Teodoro, Vinicius Cury Silva, Alessandra Braga Cruz Guedes de Morais, José Gilberto H. Vieira, George Mendes, Joao Paulo de Queiroz · 发表于：JAMA Neurology · 年份：2025 · DOI：10.1001/jamaneurol.2025.4152 · 被引用次数：5 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Blood Coagulation and Thrombosis Mechanisms

Importance: Outcomes following intravenous thrombolysis for minor ischemic stroke may vary based on the presence of disabling deficits. Objective: To determine whether intravenous tenecteplase improves outcomes according to US National Institutes of Health Stroke Scale (NIHSS) score-based definitions of pretreatment disabling deficits. Design, Setting, and Participants: This is a secondary analysis of the TEMPO-2 (Tenecteplase vs Standard of Care for Minor Ischemic Stroke With Proven Occlusion) randomized clinical trial, conducted between April 27, 2015, and January 19, 2024. Patients were followed up for 90 days. The TEMPO-2 trial was conducted across 48 sites globally among patients with minor ischemic stroke (NIHSS 0-5) and proven intracranial occlusion within 12 hours of onset. Patients were divided into having nondisabling vs disabling syndromes at presentation as per the TREAT Task Force consensus. Other established definitions of disabling stroke from the ARAMIS trial and the National Institute of Neurological Disorders and Stroke trial were explored. Data analysis was completed from July 2024 to September 2024. Interventions: Intravenous tenecteplase (0.25 mg/kg) vs nonthrombolytic standard of care. Main Outcomes and Measures: The primary outcome was a return to baseline modified Rankin scale score at 90 days. Results: Among 886 enrolled patients, 2 withdrew consent and 884 were included in the secondary analysis. Among 884 patients analyzed (369 women [41.7%]; median...