Golden Hour Thrombolysis in Acute Ischemic Stroke: The Changing Pattern in South Korea

Abstract

Intravenous tissue plasminogen activator (IV-tPA) is pivotal for the treatment of acute ischemic stroke; however, the benefit of IV-tPA treatment declines rapidly soon after stroke onset.1 These results support intensive efforts to reduce both onset-totreatment (OTT) time and door-to-treatment (DTT) time and serve as a basis for establishing an in-hospital and prehospital stroke care system. As these efforts require substantial expenditures of labor and capital, more real-world data are needed to assess the effect of golden hour thrombolysis for acute ischemic stroke. Moreover, understanding the current status and secular changes in IV-tPA treatment will be important to establish an appropriate stroke care system in the future. Therefore, we investigated the effect of golden hour thrombolysis and secular changes in time-to-treatment variables for IV-tPA for acute ischemic stroke by analyzing a prospective registry of 16 stroke centers in South Korea.