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Record W4296511648 · doi:10.1002/rth2.12795

Alteplase or tenecteplase for thrombolysis in ischemic stroke: An illustrated review

2022· review· en· W4296511648 on OpenAlexaff
Annie Zhu, Phavalan Rajendram, Eric Tseng, Shelagh B. Coutts, Amy Yu

Bibliographic record

VenueResearch and Practice in Thrombosis and Haemostasis · 2022
Typereview
Languageen
FieldMedicine
TopicAcute Ischemic Stroke Management
Canadian institutionsUniversity of CalgaryToronto Public HealthHealth Sciences CentrePublic Health OntarioUniversity of TorontoSunnybrook Health Science Centre
Fundersnot available
KeywordsTenecteplaseMedicineThrombolysisTissue plasminogen activatorStroke (engine)Intensive care medicineGuidelineFibrinolytic agentIntracerebral hemorrhageClinical trialSubarachnoid hemorrhageInternal medicineMyocardial infarctionPathology

Abstract

fetched live from OpenAlex

Intravenous thrombolysis is a standard of care treatment for patients with acute ischemic stroke. Tissue plasminogen activator (tPA) has been the main thrombolytic agent used since the publication of the seminal National Institutes of Neurological Disorders and Stroke trial in 1995. There is now mounting evidence to support the routine use of Tenecteplase (TNK) to treat acute ischemic stroke. TNK is a genetically modified tPA with higher fibrin specificity, longer half-life, and reduced systemic coagulopathy. In this illustrated review, we compare the indications, doses, mechanisms of action, efficacy and safety of TNK and tPA. We provide an overview of published clinical trials studying TNK in acute ischemic stroke, including dose-escalation studies and head-to-head comparisons with tPA. Finally, we summarize current acute stroke guideline recommendations and suggest treatment algorithms to manage the two main complications of intravenous thrombolysis: symptomatic intracerebral hemorrhage and angioedema.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.007
metaresearch head score (Gemma)0.007
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.907
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0070.007
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0030.000
Bibliometrics0.0010.002
Science and technology studies0.0000.000
Scholarly communication0.0000.001
Open science0.0000.001
Research integrity0.0000.002
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.425
GPT teacher head0.537
Teacher spread0.112 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations41
Published2022
Admission routes1
Has abstractyes

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