It is the biggest randomized thrombolysis trial for stroke ever and it answers a lot of questions, such as
- Are we safe with our (quite liberal) indications for tpa in stroke? Is the 4.5h window safe? It is, even 6h would be safe.
- Do elder patients profit? They do! And even more than the younger ones!
The IST-3 trial is methodologically very advanced, has provided an overview of its statistical evaluation in advance. And it is actually quite readable. So go ahead and view the publication and all slides on their homepage.
Added after the fact: since I am a tpa believer (having done at least 150 thrombolyses for stroke last year) I probably don’t question the statistics enough. Make sure, you don’t fall into any trap and give the tpa agnosticians a try – such as EM ireland.