Abstract
The third International Stroke Trial (IST-3) is the largest (n=3035) randomised controlled trial of intravenous alteplase for acute ischaemic stroke to date.1 Participants in IST-3 were older than in previous trials: 1617 (53%) were older than 80 years of age, whereas only 112 patients of this age were included in eight previous similar trials.2 In IST-3, participants could be treated up to 6 h after stroke onset, but 849 (28%) were treated within 3 h. No significant effect of alteplase was reported on the IST-3 primary endpoint—independence at 6 months (defined as an Oxford Handicap Scale score of 0–2).
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